Document Detail


Role of human milk in extremely low birth weight infants' risk of necrotizing enterocolitis or death.
MedLine Citation:
PMID:  18716628     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the association between human milk (HM) intake and risk of necrotizing enterocolitis (NEC) or death among infants 401 to 1000 g birth weight.
STUDY DESIGN: Analysis of 1272 infants in the National Institute of Child Health and Human Development Neonatal Network Glutamine Trial was performed to determine if increasing HM intake was associated with decreased risk of NEC or death. HM intake was defined as the proportion of HM to total intake, to enteral intake and total volume over the first 14 days. Known NEC risk factors were included as covariates in Cox proportional hazard analyses for duration of survival time free of NEC.
RESULT: Among study infants, 13.6% died or developed NEC after 14 days. The likelihood of NEC or death after 14 days was decreased by a factor of 0.83 (95% confidence interval, CI 0.72, 0.96) for each 10% increase in the proportion of total intake as HM. Each 100 ml kg(-1) increase in HM intake during the first 14 days was associated with decreased risk of NEC or death (hazard ratio, HR 0.87 (95% CI 0.77, 0.97)). There appeared to be a trend towards a decreased risk of NEC or death among infants who received 100% HM as a proportion to total enteral intake (HM plus formula), although this finding was not statistically significant (HR 0.85 (95% CI 0.60, 1.19)).
CONCLUSION: These data suggest a dose-related association of HM feeding with a reduction of risk of NEC or death after the first 2 weeks of life among extremely low birth weight infants.
Authors:
J Meinzen-Derr; B Poindexter; L Wrage; A L Morrow; B Stoll; E F Donovan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2008-08-21
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  29     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-29     Completed Date:  2009-04-23     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  57-62     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Enteral Nutrition
Enterocolitis, Necrotizing / prevention & control*
Female
Humans
Infant Mortality*
Infant, Extremely Low Birth Weight*
Infant, Newborn
Male
Milk, Human*
Risk Factors
Grant Support
ID/Acronym/Agency:
HD 13021/HD/NICHD NIH HHS; R01 HD059140/HD/NICHD NIH HHS; R01 HD059140-01/HD/NICHD NIH HHS; U10 HD021364/HD/NICHD NIH HHS; U10 HD021364-24/HD/NICHD NIH HHS; U10 HD021373-25/HD/NICHD NIH HHS; U10 HD021385/HD/NICHD NIH HHS; U10 HD021385-20/HD/NICHD NIH HHS; U10 HD021397-20/HD/NICHD NIH HHS; U10 HD021415-15/HD/NICHD NIH HHS; U10 HD027851-19/HD/NICHD NIH HHS; U10 HD027853/HD/NICHD NIH HHS; U10 HD027853-19/HD/NICHD NIH HHS; U10 HD027856-19/HD/NICHD NIH HHS; U10 HD027871-19/HD/NICHD NIH HHS; U10 HD027880-18/HD/NICHD NIH HHS; U10 HD027881-10/HD/NICHD NIH HHS; U10 HD027904/HD/NICHD NIH HHS; U10 HD027904-15/HD/NICHD NIH HHS; U10 HD034216/HD/NICHD NIH HHS; U10 HD034216-14/HD/NICHD NIH HHS; U10 HD036790-12/HD/NICHD NIH HHS; U10 HD040461-05/HD/NICHD NIH HHS; U10 HD040689-09/HD/NICHD NIH HHS
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