scholarly journals The Dose Effect of Maternal Milk on Bronchopulmonary Dysplasia in Very Low Birth Weight Infants

2020 ◽  
Author(s):  
Yan Xu ◽  
Zhangbin Yu ◽  
Qianqian Li ◽  
Jinjun Zhou ◽  
Xiaoguang Yin ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Very Low Birth Weight ◽  
Dose Effect ◽  
Human Breast Milk ◽  
Research Database ◽  
Maternal Milk ◽  
Vlbw Infants ◽  
Preterm Formula

Abstract Background Human breast milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, limited multicenter research has been reported on the association between the dose of maternal milk and BPD in China. In this study, we aimed to evaluate the dose effects of maternal milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants. Methods We conducted a retrospective cohort study of preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. Multivariate analysis was performed to compare the effect on neonatal outcomes of daily graded doses of maternal milk throughout the first 4 weeks of life versus a reference group receiving no maternal milk. Models were adjusted for potential confounding variables. Results Of 964 included infants, 279 (28.9%) received exclusive preterm formula, another 128 (13.3%) received 1–24 ml/kg, 139 (14.4%) received 25–49 ml/kg, and 418 (43.4%) received ≥ 50 ml/kg maternal milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of maternal milk daily (≥ 50 ml/kg) had lower incidences of BPD (27.5% in ≥ 50 ml/kg maternal milk vs. 40.1% in formula), moderate and severe BPD (8.9% in ≥ 50 ml/kg maternal milk vs. 16.1% in formula), necrotizing enterocolitis (NEC; 3.8% in ≥ 50 ml/kg maternal milk vs. 10.8% in formula), late-onset sepsis (LOS; 9.3% in ≥ 50 ml/kg maternal milk vs. 19.7% in formula), and extrauterine growth retardation (EUGR; 38.5% in ≥ 50 ml/kg maternal milk vs. 57.6% in formula). Logistic regression indicated that those receiving ≥ 50 ml/kg/day maternal milk had lower odds of BPD (adjusted odds ratio [AOR] 0.453; 95% confidence interval [CI]: 0.309, 0.666), moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979). Conclusions A daily threshold amount of ≥ 50 ml/kg maternal milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants. Trial registration: ClinicalTrials.gov Identifier: NCT03453502

scholarly journals Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yan Xu ◽  
Zhangbin Yu ◽  
Qianqian Li ◽  
Jinjun Zhou ◽  
Xiaoguang Yin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Very Low Birth Weight ◽  
Research Database ◽  
Vlbw Infants ◽  
Dose Dependent

Abstract Background and aim Human milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, studies on the association between the dose of human milk and BPD in China are limited. This study aimed to evaluate the dose-dependent effects of human milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants. Methods This retrospective cohort study of preterm infants was conducted on preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. The multivariate analysis was performed to compare the effect outcomes of daily graded doses [1–24 mL/(kg · day), 25–49 mL/(kg · day), and ≥ 50 mL/(kg · day) of body weight] of human milk on neonatal outcomes throughout the first 4 weeks of life versus a reference group receiving no human milk. The models were adjusted for potential confounding variables. Results Of 964 included infants, 279 (28.9%) received exclusive preterm formula, 128 (13.3%) received 1–24 ml/(kg · day), 139 (14.4%) received 25–49 ml/(kg · day), and 418 (43.4%) received ≥50 ml/(kg · day) human milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of human milk daily [≥50 mL/(kg · day)] had lower incidences of BPD [27.5% in ≥50 mL/(kg · day) vs 40.1% in 0 mL/(kg · day) human milk, P = 0.001)], moderate and severe BPD [8.9% in ≥50 mL/(kg · day) vs 16.1% in 0 mL/(kg · day), P = 0.004], necrotizing enterocolitis [NEC; 3.8% in ≥50 mL/(kg · day) vs 10.8% in 0 mL/(kg · day), P = 0.001], late-onset sepsis [LOS; 9.3% in ≥50 mL/(kg · day) vs 19.7% in 0 mL/(kg · day), P <0.01], and extrauterine growth retardation [EUGR; 38.5% in ≥50 mL/(kg · day) vs 57.6% in 0 mL/(kg · day), P <0.01)]. The logistic regression indicated that those receiving ≥50 ml/kg · day human milk had lower odds of BPD [adjusted odds ratio (AOR) 0.453; 95% confidence interval (CI): 0.309, 0.666], moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979). Conclusions A daily threshold amount of ≥50 ml/(kg · day) human milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants. Trial registration ClinicalTrials.gov Identifier: NCT03453502. Registration date: March 5, 2018. This study was retrospectively registered.

scholarly journals Incidence of bronchopulmonary dysplasia and mortality of very low birth weight infants in Vojvodina

2020 ◽  
Vol 148 (1-2) ◽  
pp. 52-57
Author(s):  
Gordana Vilotijevic-Dautovic ◽  
Aleksandra Doronjski ◽  
Gordana Vijatov-Djuric ◽  
Milena Bjelica
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Very Low Birth Weight ◽  
Developed Countries ◽  
Supplemental Oxygen ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Original Definition ◽  
Overall Mortality

Introduction/Objective. The incidence of bronchopulmonary dysplasia (BPD) varies depending on the prematurity rate, definition, and therapy that are applied at a certain center. The average incidence of BPD for very low birth weight infants (VLBW) in developed countries ranges 4?53%. The mortality of VLBW infants is high and represents 50% of the total neonatal and infant mortality. In recent years, the survival limits are shifted towards lower gestations. The aim of our study was to determine the incidence and severity of BPD in VLBW infants in Vojvodina and the overall mortality. Methods. This retrospective study was conducted from January 2006 to December 2011 and included 504 infants with birth weight < 1,500 g. Results. In the total premature infants? population, 82.3% survived by the gestational age of 36 weeks. According to the original definition of BPD, as supplemental oxygen use at 28 days of life, BPD had 45.4% of infants. According to the severity based definition 19.4% had mild BPD, 19.8% moderate BPD and 6.5% severe BPD. If BPD is observed as supplemental oxygen use at 36 weeks postmenstrual age, BPD had 26% of infants. Conclusion. The overall mortality and incidence of BPD in our study are comparable to those in some developed countries and lower compared to underdeveloped countries.

scholarly journals Hypercarbia and Not Hypocarbia Is Associated with the Risk of Bronchopulmonary Dysplasia (BPD) in Very Low Birth Weight (VLBW) Infants!: A Multicenter Study

1999 ◽  
Vol 45 (4, Part 2 of 2) ◽  
pp. 320A-320A
Author(s):  
K N Siva Subramanian ◽  
Ramasubbareddy Dhanireddy ◽  
Ayman El-Mohandes ◽  
Doris Bartel ◽  
Timothy Wilcosky ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Multicenter Study ◽  
Very Low Birth Weight ◽  
Vlbw Infants

Complicated Intubations are Associated with Bronchopulmonary Dysplasia in Very Low Birth Weight Infants

2021 ◽  
Author(s):  
Tara Glenn ◽  
Linnea Fischer ◽  
Ashley Markowski ◽  
Cara Beth Carr ◽  
Sindhoosha Malay ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Very Low Birth Weight ◽  
Cumulative Number ◽  
Vlbw Infants ◽  
Post Hoc Analysis ◽  
Multivariable Logistic Regression ◽  
Post Hoc

Objective This study aimed to evaluate the association between desaturation <60% (severe desaturation) during intubation and a total number of intubation attempts in the first week of life in very low birth weight (VLBW) infants with adverse long-term outcomes including bronchopulmonary dysplasia (BPD) and severe periventricular/intraventricular hemorrhage grade 3 or 4 (PIVH). Study Design A retrospective chart review was performed on VLBW infants intubated in the neonatal intensive care unit during the first week of life between January 2017 and July 2020. Descriptive tables were generated for two outcomes including BPD and PIVH. Multivariable logistic regression was performed for each outcome including significant predictors that differed between groups with a p-value of <0.2. Results A total of 146 patients were included. Patients with BPD or PIVH had a lower gestational age, and patients with BPD had a lower BW. Patients with BPD had a greater number of intubation attempts in the first week of life (4 vs. 3, p < 0.001). In multivariable logistic regression controlling for confounding variables, the odds developing BPD were higher for patients with increased cumulative number of intubation attempts in the first week of life (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.03–1.62, p = 0.029). Post hoc analyses revealed increased odds of developing BPD with increased number of intubation encounters in the first week of life (OR: 2.20, 95% CI: 1.04–4.82, p = 0.043). In this post hoc analysis including intubation encounters in the model; desaturation <60% during intubation in the first week of life was associated with increased odds of developing BPD (OR: 2.35, 95% CI: 1.02–5.63, p = 0.048). Conclusion The odds of developing BPD for VLBW infants were higher with increased intubation attempts and intubation encounters. In a post hoc analysis, the odds of developing BPD were also higher with desaturation during intubation. Further research is needed to determine mechanisms of the relationship between complicated intubations and the development of BPD. Key Points

scholarly journals Impact of Donor Milk on Short- and Long-Term Growth of Very Low Birth Weight Infants

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 241 ◽  
Author(s):  
Rebecca Hoban ◽  
Michael Schoeny ◽  
Anita Esquerra-Zwiers ◽  
Tanyaporn Kaenkumchorn ◽  
Gina Casini ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Short Term ◽  
Post Discharge ◽  
Vlbw Infants ◽  
Preterm Formula ◽  
Z Scores ◽  
Short And Long Term

Mother’s own milk (MOM) reduces the risk of morbidities in very low birth weight (VLBW) infants. When MOM is unavailable, donor breastmilk (DM) is used, with unclear impact on short- and long-term growth. This retrospective analysis compared anthropometric data at six time points from birth to 20–24 months corrected age in VLBW infants who received MOM supplements of preterm formula (n = 160) versus fortified DM (n = 161) during neonatal intensive care unit (NICU) hospitalization. The cohort was 46% female; mean birth weight and gestational age (GA) were 998 g and 27.3 weeks. Multilevel linear growth models assessed changes in growth z-scores short-term (to NICU discharge) and long-term (post-discharge), controlling for amount of DM or formula received in first 28 days of life, NICU length of stay (LOS), birth GA, and sex. Z-scores for weight and length decreased during hospitalization but increased for all parameters including head circumference post-discharge. Short-term growth was positively associated with LOS and birth GA. A higher preterm formula proportion, but not DM proportion, was associated with slower rates of decline in short-term growth trajectories, but feeding type was unrelated to long-term growth. In conclusion, controlling for total human milk fed, DM did not affect short- or long-term growth.

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