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Mother's Own Milk and Its Relationship to Growth and Morbidity in a Population-based Cohort of Extremely Preterm Infants

Lund, Anna My LU ; Domellöf, Magnus ; Pivodic, Aldina ; Hellström, Ann LU ; Stoltz Sjöström, Elisabeth LU and Hansen-Pupp, Ingrid LU orcid (2022) In Journal of Pediatric Gastroenterology and Nutrition 74(2). p.292-300
Abstract

Objectives:The aim of the study was to evaluate the relationships between intake of mother's own milk (MOM), compared with intake of pasteurized donor milk (DM), and postnatal growth, incidence of retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD), in extremely preterm infants.Methods:Swedish population-based cohort of surviving extremely preterm infants born 2004 to 2007. Exposure to MOM and DM was investigated from birth until 32 weeks postmenstrual age (PMA) in 453 infants. Primary outcome variables were change in z-score (Δ) from birth to 32 weeks PMA for weight, length, and head circumference (HC). Secondary outcomes were incidence of ROP and BPD. Mixed models adjusting for confounders were used to investigate... (More)

Objectives:The aim of the study was to evaluate the relationships between intake of mother's own milk (MOM), compared with intake of pasteurized donor milk (DM), and postnatal growth, incidence of retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD), in extremely preterm infants.Methods:Swedish population-based cohort of surviving extremely preterm infants born 2004 to 2007. Exposure to MOM and DM was investigated from birth until 32 weeks postmenstrual age (PMA) in 453 infants. Primary outcome variables were change in z-score (Δ) from birth to 32 weeks PMA for weight, length, and head circumference (HC). Secondary outcomes were incidence of ROP and BPD. Mixed models adjusting for confounders were used to investigate the association between exposures and outcomes.Results:Infants' mean gestational age (GA) was 25.4 weeks. Unadjusted, MOM (per 10 mL · kg-1 · day-1) was associated with Δweight and ΔHC with beta estimates of 0.03 z-score units (95% CI, 0.02-0.04, P < 0.001) and 0.03 z-score units (95% CI, 0.01-0.05, P = 0.003), respectively. After adjustment for predefined confounders, the association remained significant for Δweight and ΔHC. A similar pattern was found between Δweight and each 10% increase of MOM. Unadjusted, a higher intake of MOM (mL · kg-1 · day-1) was significantly associated to a lower probability of any ROP and severe ROP; however, these associations did not remain in the adjusted analyses. No associations were found between MOM (mL · kg-1 · day-1) and BPD. Moreover, no associations were found between DM and growth or morbidity outcomes.Conclusions:An increased intake of MOM, as opposed to DM (and not formula feeding), was associated with improved postnatal weight gain and HC growth from birth until 32 weeks PMA in extremely preterm infants. Interventions aiming at increasing early intake of unpasteurized MOM for extremely preterm infants should be encouraged.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bronchopulmonary dysplasia, donor milk, human milk, pasteurization, retinopathy of prematurity
in
Journal of Pediatric Gastroenterology and Nutrition
volume
74
issue
2
pages
9 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85123901078
  • pmid:34759238
ISSN
0277-2116
DOI
10.1097/MPG.0000000000003352
language
English
LU publication?
yes
id
42450a23-b292-456d-83b0-0497906b66ec
date added to LUP
2022-03-25 11:30:48
date last changed
2024-03-06 03:10:38
@article{42450a23-b292-456d-83b0-0497906b66ec,
  abstract     = {{<p>Objectives:The aim of the study was to evaluate the relationships between intake of mother's own milk (MOM), compared with intake of pasteurized donor milk (DM), and postnatal growth, incidence of retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD), in extremely preterm infants.Methods:Swedish population-based cohort of surviving extremely preterm infants born 2004 to 2007. Exposure to MOM and DM was investigated from birth until 32 weeks postmenstrual age (PMA) in 453 infants. Primary outcome variables were change in z-score (Δ) from birth to 32 weeks PMA for weight, length, and head circumference (HC). Secondary outcomes were incidence of ROP and BPD. Mixed models adjusting for confounders were used to investigate the association between exposures and outcomes.Results:Infants' mean gestational age (GA) was 25.4 weeks. Unadjusted, MOM (per 10 mL · kg<sup>-1</sup> · day<sup>-1</sup>) was associated with Δweight and ΔHC with beta estimates of 0.03 z-score units (95% CI, 0.02-0.04, P &lt; 0.001) and 0.03 z-score units (95% CI, 0.01-0.05, P = 0.003), respectively. After adjustment for predefined confounders, the association remained significant for Δweight and ΔHC. A similar pattern was found between Δweight and each 10% increase of MOM. Unadjusted, a higher intake of MOM (mL · kg<sup>-1</sup> · day<sup>-1</sup>) was significantly associated to a lower probability of any ROP and severe ROP; however, these associations did not remain in the adjusted analyses. No associations were found between MOM (mL · kg<sup>-1</sup> · day<sup>-1</sup>) and BPD. Moreover, no associations were found between DM and growth or morbidity outcomes.Conclusions:An increased intake of MOM, as opposed to DM (and not formula feeding), was associated with improved postnatal weight gain and HC growth from birth until 32 weeks PMA in extremely preterm infants. Interventions aiming at increasing early intake of unpasteurized MOM for extremely preterm infants should be encouraged.</p>}},
  author       = {{Lund, Anna My and Domellöf, Magnus and Pivodic, Aldina and Hellström, Ann and Stoltz Sjöström, Elisabeth and Hansen-Pupp, Ingrid}},
  issn         = {{0277-2116}},
  keywords     = {{bronchopulmonary dysplasia; donor milk; human milk; pasteurization; retinopathy of prematurity}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{2}},
  pages        = {{292--300}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Pediatric Gastroenterology and Nutrition}},
  title        = {{Mother's Own Milk and Its Relationship to Growth and Morbidity in a Population-based Cohort of Extremely Preterm Infants}},
  url          = {{http://dx.doi.org/10.1097/MPG.0000000000003352}},
  doi          = {{10.1097/MPG.0000000000003352}},
  volume       = {{74}},
  year         = {{2022}},
}