Does Breastmilk Influence the Development of Bronchopulmonary Dysplasia?

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• 作者：Juliane Spiegler ; MD¹ ; ^{uni@dr-spiegler.de" class="auth_mail" title="E-mail the corresponding author} ; Michael Preuß ; PhD² ; Corinna Gebauer ; MD³ ; Meike Bendiks ; MD¹ ; Egbert Herting ; PhD¹ ; Wolfgang Gö ; pel ; MD¹ ; on behalf of the German Neonatal Network (GNN)^&lowast ; ; Meike Bendiks ; MD ; Martin A. Bergh&auml ; user ; MD ; Kai Bö ; ckenholt ; MD ; Bettina Bohnhorst (Prof) ; Ralf Bö ; ttger ; MD ; Thomas Brune (Prof) ; Kristin Dawczynski ; MD ; Michael Dö ; rdelmann ; MD ; Silke Ehlers ; MD ; Joachim G. Eichhorn ; MD ; Ursula Felderhoff-Mü ; ser (Prof) ; Axel Franz ; MD ; Corinna Gebauer ; MD ; Hubert Gerleve ; MD ; Wolfgang Gö ; pel (Prof) ; Ludwig Gortner (Prof) ; Roland Haase ; MD ; Friedhelm Heitmann ; MD ; Roland Hentschel (Prof) ; Nico Hepping ; MD ; Georg Hillebrand ; MD ; Thomas Hö ; hn (Prof) ; Isabelle Hö ; rnig-Franz ; MD ; Mechthild Hubert ; MD ; Andreas Jenke ; MD ; Rainer Jensen ; MD ; Olaf Kannt ; MD ; Hans T. Kö ; rner ; MD ; Angela Kribs ; MD ; Helmut Kü ; ster ; MD ; Knud Linnemann ; MD ; Jens Mö ; ller (Prof) ; Andreas Mü ; ller (Prof) ; Dirk Mü ; ller ; MD ; Dirk M. Olbertz ; MD ; Thorsten Orlikowsky (Prof) ; Jochen Reese ; MD ; Claudia Roll (Prof) ; Rainer Rossi (Prof) ; Mario Rü ; diger (Prof) ; Thomas Schaible ; MD ; Jan-Holger Schiffmann (Prof) ; Susanne Schmidkte ; MD ; Stephan Seeliger ; MD ; Hugo Segerer (Prof) ; Jens Siegel ; MD ; Norbert Teig ; MD ; Florian Urlichs ; MD ; Axel von der Wense ; MD ; Matthias Vochem ; MD ; Ursula Weller ; MD ; Christian Wieg ; MD ; Jü ; rgen Wintgens ; MD
• 关键词：BPD ; Bronchopulmonary dysplasia ; CRIB ; Clinical risk index for babies ; IVH ; Intraventricular hemorrhage ; NEC ; Necrotizing enterocolitis ; ROP ; Retinopathy of prematurity ; VLBW ; Very low birth weight
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：169
• 期：Complete
• 页码：76-80.e4
• 全文大小：237 K

文摘

To assess whether breastmilk feeding is associated with a reduced risk of bronchopulmonary dysplasia (BPD). Secondary outcome measures analyzed were retinopathy of prematurity (ROP) and necrotizing enterocolitis (NEC).

Study design

spara0015">In an ongoing multicenter cohort study, the data of 1433 very low birth weight infants born before 32 weeks of gestation and discharged in 2013 were analyzed. We compared growth and neonatal complications of infants who received breastmilk exclusively (N = 223) with those who received formula feedings exclusively (N = 239). Logistic regression models were estimated for BPD, ROP, and NEC using nutrition as an independent variable. The Firth logistic regression model and Lasso were used for sensitivity analyses.

Results

spara0020">Exclusively breastmilk-fed infants gained less weight compared with formula-fed infants. SDS for weight decreased between birth and discharge (median (Q1-Q3): formula −0.9 (−1.4 to [−0.5]) vs breastmilk −1.1 (−1.7 to [−0.6])). Exclusive formula feeding of very low birth weight infants was associated with increased risks of BPD (OR 2.6) as well as NEC (OR 12.6) and ROP (OR 1.80) after controlling for known risk factors.

Conclusions

spara0025">Exclusive breastmilk feeding was associated with lower growth rates and a reduced risk of BPD as well as NEC and ROP.