Arayici Sema, Alyamac Dizdar Evrim, Kadioglu Simsek Gulsum, Sari Fatma Nur
Division of Neonatology, Department of Pediatrics, Akdeniz University School of Medicine, Antalya, Turkiye.
Division of Neonatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkiye.
J Hum Lact. 2025 Aug;41(3):371-378. doi: 10.1177/08903344251342561. Epub 2025 Jun 29.
Human milk and colostrum have been well studied; however, limited data are available on the variations in macronutrient content when compared across different infant weight categories for infants with similar gestational ages.
To compare the colostrum macronutrient content of participants who delivered term infants classified as small for gestational age, appropriate for gestational age, and large for gestational age.
In this exploratory cross-sectional observational study ( = 252), colostrum (on postpartum Day 2) was collected and categorized by gestational weight group. The protein, fat, carbohydrate, and energy levels of colostrum were measured using a mid-infrared human milk analyzer. Values were dichotomized at the median and compared using logistic regression.
Median colostrum protein content was significantly higher in the small for gestational age (4.8 [IQR = 3-6.4] gr/dl) and large for gestational age (4.4 [IQR = 3.5-5.3] g/dl) groups compared to the appropriate for gestational age group (2.8 [IQR = 2.1-3.7] g/dl; < 0.001). Median carbohydrate content was significantly higher in the large for gestational age group (5.3 [IQR = 4.2-6] g/dl) than appropriate for gestational age group (4.5 [IQR = 3.5-5.3] g/dl; = 0.002). In multivariate analysis, being SGA or LGA was independently associated with higher milk protein content ( 4.68; 95% CI [2.25, 9.77; < 0.001; and 6.76; 95% CI [3.30, 13.87]; < 0.001, respectively). Only being LGA was associated with higher carbohydrate content ( 2.74; 95% CI [1.46, 5.16]; = 0.002).
Colostrum macronutrient content varies depending on whether the birthweight is small or large for gestational age. Studies are needed to investigate these potential associations and the clinical consequences of this relationship.
人乳和初乳已得到充分研究；然而，对于胎龄相似的婴儿，按不同出生体重类别比较时，宏量营养素含量变化的数据有限。
比较分娩出的足月儿中，出生体重小于胎龄、适于胎龄和大于胎龄的参与者的初乳宏量营养素含量。
在这项探索性横断面观察性研究（n = 252）中，收集了初乳（产后第2天）并按出生体重组进行分类。使用中红外人乳分析仪测量初乳的蛋白质、脂肪、碳水化合物和能量水平。数值以中位数进行二分法划分，并使用逻辑回归进行比较。
与适于胎龄组（2.8 [四分位间距 = 2.1 - 3.7] g/dl；P < 0.001）相比，小于胎龄组（4.8 [四分位间距 = 3 - 6.4] g/dl）和大于胎龄组（4.4 [四分位间距 = 3.5 - 5.3] g/dl）的初乳蛋白质含量中位数显著更高。大于胎龄组（5.3 [四分位间距 = 4.2 - 6] g/dl）的碳水化合物含量中位数显著高于适于胎龄组（4.5 [四分位间距 = 3.5 - 5.3] g/dl；P = 0.002）。在多变量分析中，小于胎龄或大于胎龄与更高的乳蛋白含量独立相关（比值比分别为4.68；95%置信区间[2.25, 9.77]；P < 0.001；以及6.76；95%置信区间[3.30, 13.87]；P < 0.001）。只有大于胎龄与更高的碳水化合物含量相关（比值比为2.74；95%置信区间[1.46, 5.16]；P = 0.002）。
初乳宏量营养素含量因出生体重小于或大于胎龄而异。需要开展研究来调查这些潜在关联以及这种关系的临床后果。
