背景:母乳含有各种关键营养素和生物活性物质,是新生儿的理想选择。本研究旨在分析早产儿和足月儿母亲的母乳成分及其对婴儿生长发育的影响。
方法:纳入在我院(2016年3月至2017年5月)检查的婴儿-母亲二联体。牛奶在0-1个月收集,2-3个月,和5-6个月,并使用MIRIS人乳分析仪进行分析。Z-长度体重(WLZ)评分,年龄体重(WAZ),和年龄长度(LAZ)进行计算。
结果:这项研究包括足月(>妊娠37周,n=177)和早产(<37周,n=94)婴儿-母亲二元系。早产儿表现出更高的ΔWAZ,ΔLAZ,从婴儿期到幼儿期的ΔWLZ用于身体生长速度,与足月婴儿相比(P<0.001)。母乳中的所有蛋白质和真实蛋白质成分均随婴儿年龄的增加而减少(P<0.001)。对于早产儿和足月婴儿,从出生到婴儿期的ΔWAZ和ΔLAZ的差异以及ΔLAZ的差异,WAZ,幼儿期LAZ与非蛋白氮(NPN)呈正相关(均P<0.05),而从出生到婴儿的ΔWLZ的Z评分差异与NPN呈负相关(均P<0.05)。对于早产儿,从出生到婴儿期,ΔWAZ与NPN和碳水化合物呈正相关,与干物质呈负相关(均P<0.05)。ΔLAZ与NPN相关(β=0.428,P=0.005)。
结论:与足月婴儿相比,母乳喂养有助于早产儿代偿性生长。在婴儿期早期的ΔWLZ增益与母乳中NPN含量的增加呈负相关。这可能意味着尽管NPN增加了年龄体重和年龄长度的Z得分,脂肪组织没有增加。
BACKGROUND: Breast milk contains various crucial nutrients and biologically active substances and is ideal for newborns. This study aimed to analyze the composition of breast milk from mothers of premature and full-term infants and its influences on the growth of infants.
METHODS: Infant-mother dyads examined at our Hospital (March 2016 to May 2017) were included. Milk was collected at 0-1 month, 2-3 months, and 5-6 months and analyzed using a MIRIS human milk analyzer. Z-scores of weight-for-length (WLZ), weight-for-age (WAZ), and length-for-age (LAZ) were calculated.
RESULTS: This study included full-term (> 37 weeks of gestation, n = 177) and premature (< 37 weeks, n = 94) infant-mother dyads. The premature infants showed higher ΔWAZ, ΔLAZ, and ΔWLZ from infancy to toddlerhood for the physical growth speed, compared with term infants (P < 0.001). All proteins and true protein components of breast milk decreased with infants\' age (P < 0.001). For premature and full-term infants, differences in ΔWAZ and ΔLAZ from birth to infancy and the difference in ΔLAZ, WAZ, and LAZ in toddlerhood were positively associated with non-protein nitrogen (NPN) (all P < 0.05), while the Z-score differences in ΔWLZ from birth to infancy were negatively associated with NPN (all P < 0.05). For premature babies, from birth to infancy stage, ΔWAZ was positively correlated with NPN and carbohydrates while negatively correlated with dry matter (all P < 0.05), and ΔLAZ correlated with NPN (β = 0.428, P = 0.005).
CONCLUSIONS: Breastfeeding helped premature infants compensatory growth when compared to term infants. Whileduring early infancy stage ΔWLZ gain was negatively associated with increased amounts of NPN in breast milk. This might mean although NPN increase the Z-scores of weight-for-age and length-for-age, with no rise in adipose tissue mass.