■人乳,早产儿的最终营养来源,增强主机防御机制,胃肠成熟,降低感染率,改善神经发育结果,并减少长期心血管和代谢性疾病。最近,早产儿的供体母乳(DBM)使用有所增加;然而,关于DBM对婴儿生长和神经发育结果的长期影响的数据有限。
■确定极低出生体重(VLBW)婴儿的婴儿营养类型(母体母乳(MBM)或DBM)与神经发育和生长结局之间是否存在关联。
■2014年1月至2016年12月,BaylorScott&White纪念医院新生儿重症监护病房收治的VLBW(<1500g)婴儿的回顾性队列研究。有重大先天性异常的婴儿,出生在外面的医院,在超过15天的时间内,每个操作系统(NPO)为零,或在NICU出院前死亡的患者被排除在外.根据出生后第一个月接受的主要营养(>50%),将婴儿分为两组(MBM或DBM)。通过ICD9/10编码确定的2至4岁之间的神经发育延迟的主要结果。生长数据(体重,长度,和头围)是从12-,18-,24-,36-,和48个月。使用婴儿II临床风险指数(CRIB-II)评分确定疾病的严重程度。使用广义线性模型来评估营养与神经发育延迟之间的关系以及随时间的增长趋势。
■包括二百九名婴儿:146MBM;63DBM。中位胎龄为28周(范围,23-35),中位出生体重为1050g(范围,410-1470)。出生体重没有显着差异,胎龄,CRIB-II评分,或小组之间的停留时间。饲喂DBM的婴儿体重z得分明显更大(p=0.005),长度z分数(p=.01),和头围z分数(p=.04),与MBM婴儿相比,平均从出生到48个月,同时控制NICU的住院时间和随访月数;然而,这只相当于DBM婴儿在48个月时身高0.5磅,体重0.9磅。婴儿营养类型和长期神经发育结局之间没有统计学上的显着差异。同时控制CRIB-II评分。
■与饲喂MBM的婴儿相比,饲喂DBM的婴儿随着时间的推移具有稍微更大的生长倾向。需要更长时间的随访以进一步确定效果,婴儿营养对神经发育的影响。
UNASSIGNED: Human milk, the ultimate source of nutrition for premature infants, enhances host defense mechanism, gastrointestinal maturation, lowers infection rate, improves neurodevelopmental outcomes, and reduces long-term cardiovascular and metabolic disease. Recently, there has been an increase in donor breast milk (DBM) use for premature infants; however, data are limited on the long-term effects of DBM on the infant\'s growth and neurodevelopmental outcomes.
UNASSIGNED: To determine if there is an association between type of infant nutrition (maternal breast milk (MBM) or DBM) and neurodevelopmental and growth outcomes in very low birth weight (VLBW) infants.
UNASSIGNED: Retrospective cohort study of VLBW (<1500 g) infants admitted to the Baylor Scott & White Memorial Hospital Neonatal Intensive Care Unit from January 2014 to December 2016. Infants with major congenital anomalies, born at an outside hospital, who were nil per os (NPO) for >15 days, or who died before NICU discharge were excluded. Infants were stratified into two groups (MBM or DBM) based on predominant nutrition (>50%) received in the first month of life. Primary outcomes of neurodevelopmental delay(s) between 2 and 4 years of age identified via ICD 9/10 codes. Growth data (weight, length, and head circumference) were obtained from well-check visits at 12-, 18-, 24-, 36-, and 48-months. Severity of illness was determined using the Clinical Risk Index in Babies-II (CRIB-II) score. Generalized linear models were used to assess the relationship between nutrition and neurodevelopmental delay and trends in growth over time.
UNASSIGNED: Two hundred and nine infants were included: 146 MBM; 63 DBM. Median gestational age was 28 weeks (range, 23-35) and median birthweight was 1050 g (range, 410-1470). There were no significant differences in birthweight, gestational age, CRIB-II score, or length of stay between the groups. Infants fed DBM had a significantly larger weight z-score (p=.005), length z-score (p=.01), and head circumference z-score (p=.04), on average from birth to 48 months compared to MBM infants, while controlling for NICU length of stay and number of follow-up months; however, this only equated to DBM infants being 0.5 in taller and 0.9 lbs heavier at 48 months. There were no statistically significant differences among type of infant nutrition and long-term neurodevelopmental outcomes, while controlling for CRIB-II score.
UNASSIGNED: Infants fed DBM have a slightly greater propensity for growth over time compared to infants fed MBM. Longer follow-up is needed to further determine the effect, infant nutrition has on neurodevelopmental outcomes.