Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants
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RESEARCH ARTICLE
Open Access
Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants Yan Xu1,2†, Zhangbin Yu2†, Qianqian Li3†, Jinjun Zhou4†, Xiaoguang Yin5†, Yuelan Ma6†, Yujie Yin7†, Shanyu Jiang8†, Rongping Zhu9†, Yue Wu10†, Liangrong Han11†, Yan Gao12†, Mei Xue13†, Yu Qiao14†, Lingling Zhu15†, Wenjuan Tu16†, Mingfu Wu17†, Jun Wan18†, Weiyuan Wang19†, Xiaoyi Deng3, Shuangshuang Li4, Sannan Wang6, Xiaoqing Chen7, Qin Zhou8, Jinxiu Wang9, Rui Cheng10, Jun Wang1* and Shuping Han2,20*
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 (Continued on next page)
* Correspondence: [email protected]; [email protected] † Yan Xu, Zhangbin Yu, Qianqian Li, Jinjun Zhou, Xiaoguang Yin, Yuelan Ma, Yujie Yin, Shanyu Jiang, Rongping Zhu, Yue Wu, Liangrong Han, Yan Gao, Mei Xue, Yu Qiao, Lingling Zhu, Wenjuan Tu, Mingfu Wu, Jun Wan and Weiyuan Wang contributed equally to this work. 1 Department of Neonatology, The Affiliated Hospital of Xuzhou Medical University, No. 99, Huaihai West Road, Xuzhou 221000, Jiangsu Province, China 2 Department of Neonatology, The Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, Jiangsu, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, whic
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