Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age
Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age
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DOI：
10.1542/peds.2006-3227
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发表时间：
2007-10-01
期刊：
影响因子：
8
通讯作者：
Poole, W. Kenneth
中科院分区：
文献类型：
--
作者：
Vohr, Betty R.;Poindexter, Brenda B.;Poole, W. Kenneth
背景我们先前报道了在新生儿重症监护病房中，极低出生体重儿摄入母乳对18个月矫正年龄的发育结果的有益影响。本研究的目的是确定母乳对极低出生体重儿的这些影响是否持续到30个月的校正年龄。前瞻性收集营养数据，包括肠内和肠外喂养，并对773名极低出生体重婴儿进行30个月的校正年龄随访评估，这些婴儿参加了国家儿童健康和人类发展研究所新生儿研究网络谷氨酰胺试验。在新生儿住院期间，共有593名新生儿摄入了一些母乳，180名新生儿没有摄入母乳。分析新生儿喂养特征和发病率以及30个月的中期病史、神经发育结局和生长参数。将儿童分为母乳量的五分之一，以评估在NICU住院期间摄入的母乳量的影响。结果。在30个月时，母乳摄入量的增加与更高的贝利精神发育指数评分，更高的贝利行为评分和情绪调节相关，并且出院至30个月之间的再住院率更低。在生长参数或脑瘫方面没有差异。母乳每增加10 mL/kg/d，智力发育指数增加0.59分，精神发育指数增加0.56分，总行为百分位数增加0.99分，出院至30个月再住院的风险降低5%。在新生儿重症监护室中摄入母乳的有益影响持续到30个月的校正年龄，在这个脆弱的极低出生体重人口。必须继续努力，为新生儿重症监护病房和出院后的所有极低出生体重婴儿提供母乳。
BACKGROUND. We previously reported beneficial effects of breast milk ingestion by infants with extremely low birth weight in the NICU on developmental outcomes at 18 months' corrected age. The objective of this study was to determine whether these effects of breast milk in infants with extremely low birth weight persisted at 30 months' corrected age.METHODS. Nutrition data, including enteral and parenteral feeds, were prospectively collected, and 30 months' corrected age follow-up assessments were completed on 773 infants with extremely low birth weight who participated in the National Institute of Child Health and Human Development Neonatal Research Network Glutamine Trial. A total of 593 ingested some breast milk during the neonatal hospitalization, and 180 ingested none. Neonatal feeding characteristics and morbidities and 30-month interim history, neurodevelopmental outcomes, and growth parameters were analyzed. Children were divided into quintiles of breast milk volume to evaluate the effects of volume of human milk ingested during the NICU hospitalization.RESULTS. At 30 months, increased ingestion of breast milk was associated with higher Bayley Mental Developmental Index scores, higher Bayley behavior score percentiles for emotional regulation, and fewer rehospitalizations between discharge and 30 months. There were no differences in growth parameters or cerebral palsy. For every 10 mL/kg per day increase in breast milk, the Mental Developmental Index increased by 0.59 points, the Psychomotor Developmental Index by 0.56 points, and the total behavior percentile score by 0.99 points, and the risk of rehospitalization between discharge and 30 months decreased by 5%.CONCLUSIONS. Beneficial effects of ingestion of breast milk in the NICU persist at 30 months' corrected age in this vulnerable extremely low birth weight population. Continued efforts must be made to offer breast milk to all extremely low birth weight infants both in the NICU and after discharge.