Ma Yanmei, Pang Xuehong, Xu Tao, Chen Bowen, Wang Yuying, Zhang Qian, Zhao Wenhua, Yang Zhenyu
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Human Milk Science, Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Public Nutrition and Health, Beijing 100050, China.
National Maternal and Child Health Center, Chinese Center for Disease Control and Prevention, Beijing 100081, China.
Wei Sheng Yan Jiu. 2025 May;54(3):375-383. doi: 10.19813/j.cnki.weishengyanjiu.2025.03.004.
To explore the relationship between feeding patterns and physical growth of late preterm infants with 34-36 weeks of gestational age and 0-5 months of correction age.
The data were from the project "Nutrition and Health System Survey and Application for Children aged 0-18 Years in China". Multi-stage stratified random sampling was used to conduct the study at 28 survey sites in 7 regions of East China, North China, Central China, South China, Southwest, Northwest and Northeast China from February 2018 to January 2020. A self-designed structured questionnaire for infants aged 0-6 months was used by the investigators to ask infant mothers or other primary guardians face-to-face to retrospectively collect the basic characteristics and feeding status of infants, and measure the length, weight and head circumference of infants. Based on inclusion criteria and exclusion criteria, a total of 48 late preterm infants fed exclusively breastmilk and 53 late preterm infants fed formula aged 0-5 months of correction age were enrolled in this study. Using the corrected age and gender of late preterm infants fed exclusively breastmilk as matching variables, 48 full-term infants fed exclusively breastmilk aged 0-5 months were matched by propensity score as reference to evaluate the difference in growth and development between late preterm infants and full-term infants fed exclusively breastmilk. Z-scores and weight gain rate were used to evaluate the growth and development of infants. ANOVA was used to compare the growth and development of infants in the three groups. Multiple linear regression was used to adjust for potential confusing factors to analyze the effects of different feeding patterns on the growth and development of late preterm infants.
There was no significant difference in length for age Z-score(LAZ), weight for age Z-score(WAZ), weight for height Z-score(WLZ), body mass index for age Z-score(BAZ) and weight gain rate between late preterm infants fed exclusively breastmilk and late preterm infants fed formula(P>0.05), and there was also no significant difference between late preterm infants fed exclusively breastmilk and full-term infants fed exclusively breastmilk(P>0.05). However, The WAZ and head circumference for age Z-score(HCZ) of late preterm infants fed formula were 0.41(P=0.03) and 0.44(P=0.02) higher than those of full-term infants fed exclusively breastmilk, but there was no significant difference in LAZ, WLZ, BAZ and weight gain rate between the two groups(P>0.05).
At 0-5 months of correction age, the growth and development of late preterm infants fed exclusively breastmilk were similar to that of full-term infants fed exclusively breastmilk. Formula supplementation may promote weight gain, but not length in late preterm infants.
探讨胎龄34 - 36周、矫正年龄0 - 5个月的晚期早产儿喂养方式与体格生长的关系。
数据来自“中国0 - 18岁儿童营养与健康状况监测及应用”项目。2018年2月至2020年1月,采用多阶段分层随机抽样方法,在中国东部、华北、华中、华南、西南、西北和东北7个地区的28个调查点开展研究。调查员使用自行设计的0 - 6个月婴儿结构化问卷,对婴儿母亲或其他主要监护人进行面对面询问,回顾性收集婴儿的基本特征和喂养状况,并测量婴儿的身长、体重和头围。根据纳入标准和排除标准,本研究共纳入48例矫正年龄0 - 5个月、纯母乳喂养的晚期早产儿和53例矫正年龄0 - 5个月、人工喂养的晚期早产儿。以纯母乳喂养的晚期早产儿的矫正年龄和性别作为匹配变量,通过倾向得分匹配48例矫正年龄0 - 5个月、纯母乳喂养的足月儿作为对照,评估晚期早产儿和纯母乳喂养足月儿生长发育的差异。采用Z评分和体重增加率评估婴儿的生长发育情况。采用方差分析比较三组婴儿的生长发育情况。采用多元线性回归调整潜在混杂因素,分析不同喂养方式对晚期早产儿生长发育的影响。
纯母乳喂养的晚期早产儿与人工喂养的晚期早产儿在年龄别身长Z评分(LAZ)、年龄别体重Z评分(WAZ)、身高别体重Z评分(WLZ)、年龄别体质指数Z评分(BAZ)和体重增加率方面差异无统计学意义(P>0.05),纯母乳喂养的晚期早产儿与纯母乳喂养的足月儿之间差异也无统计学意义(P>0.05)。然而,人工喂养的晚期早产儿的WAZ和年龄别头围Z评分(HCZ)分别比纯母乳喂养的足月儿高0.41(P = 0.03)和0.44(P = 0.02),但两组在LAZ、WLZ、BAZ和体重增加率方面差异无统计学意义(P>0.05)。
矫正年龄0 - 5个月时,纯母乳喂养的晚期早产儿的生长发育与纯母乳喂养的足月儿相似。补充配方奶可能促进晚期早产儿体重增加,但对身长无促进作用。