title: Necrotizing Enterocolitis and Growth in Preterm Infants Fed Predominantly Maternal Milk, Pasteurized Donor Milk, or Preterm Formula: A Retrospective Study.
abstract: ObjectiveTo evaluate the association between necrotizing enterocolitis (NEC), growth, and feeding.MethodsThis is a retrospective study of 551 infants (birth weight ≤ 1,500 g, ≤32 weeks' gestation). NEC, Bell's stage ≥ 2, was confirmed by independent review of sentinel radiographs. Feeding type was defined as ≥ 50% maternal milk (MM), pasteurized donor human milk (PDHM), or preterm formula (PF). Demographic and clinical characteristics including growth were compared between the three groups. Multivariable regression analysis was performed to control variables that differed in bivariate analysis.ResultsPDHM and PF mothers were more likely to be African-American, be enrolled in Medicaid, and have chorioamnionitis. PF mothers received antenatal steroids less frequently. NEC rates were different by feeding group (MM: 5.3%; PHDM: 4.3%; PF: 11.4%;p= 0.04). Adjusting for group differences, lower gestational age (adjusted odds ratio [aOR]: 0.85; 95% confidence interval [CI]: 0.74-0.97;p= 0.02], and PF (aOR: 2.53; 95% CI: 1.15-5.53;p= 0.02] were associated with NEC. There were no differences in other health outcomes or growth at hospital discharge.ConclusionMM and PDHM feedings, given until 34 weeks postmenstrual age, were associated with lower rates of NEC in very low birth weight infants without interfering with growth.
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Novant Health Forsyth Medical Center, Winston-Salem, North Carolina.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Sisk
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Novant Health Forsyth Medical Center, Winston-Salem, North Carolina.
authors.forename: Tinisha M
authors.initials: TM
authors.lastname: Lambeth
authors.affiliation: Department of Pediatrics, Industrial University of Santander, Bucaramanga, Santander, Colombia.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Rojas
authors.affiliation: Department of Clinical Nutrition, Children's National Medical Center, Washington, District of Columbia.
authors.forename: Teisha
authors.initials: T
authors.lastname: Lightbourne
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Novant Health Forsyth Medical Center, Winston-Salem, North Carolina.
authors.forename: Maria
authors.initials: M
authors.lastname: Barahona
authors.affiliation: Department of Radiology, Brenner Children's Hospital, Wake Forest Baptist Medical Center, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Anthony
authors.affiliation: Department of Radiology, Novant Health Forsyth Medical Center, Winston-Salem, North Carolina.
authors.forename: Sam T
authors.initials: ST
authors.lastname: Auringer
mesh_terms: D001724:Birth Weight; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D016015:Logistic Models; D008297:Male; D008895:Milk, Human; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D010288:Parenteral Nutrition / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies