Association between type of feeding at discharge from the hospital and nutritional status of very low birth weight preterm infants

The ideal feeding for premature babies has been the source of extensive debate. The aim of this study was to assess the association between type of feeding at discharge and the nutritional status of very low birth weight infants. This was a retrospective cohort of preterm babies with birth weight ≤1500 g, born between January 2006 and December 2013. The infants were divided into 3 groups according to type of feeding at discharge: exclusive breast milk (group 1), mixed feeding (group 2) and exclusive artificial formula (group 3). Frequencies of each group were calculated, as well as mean Z-score differences in weight, length and head circumference. Six hundred and forty-nine newborns were included. The mean weight of groups 1, 2, and 3 was 1338.7, 1104.0, and 1254.7 g, respectively, and their mean gestational age was 31.9, 30, and 31.2 weeks, respectively. The Z-score differences (means±SD) for groups 1, 2, and 3 were: −0.84±0.68, −1.02±0.75, and −0.86±0.71 for weight, −0.21±1.23, −0.52±1.64 and −0.08±1.34 for head circumference, and −1.10±1.18, −1.54±1.37, and −0.97±1.21 for length. A significant difference was observed between groups 2 and 3 in the adjusted Z-score model for length, with no significant differences in anthropometric measurements for the other comparative analyses. Because of its many advantages, breastfeeding should be stimulated within neonatal units since nutritional status was not influenced by the different types of feeding.

早产儿理想喂养方案的选择长期以来都是学界广泛争议的话题。本研究旨在评估出院时喂养方式与极低出生体重儿营养状况之间的关联。本研究为回顾性队列研究，纳入2006年1月至2013年12月期间出生的出生体重≤1500g的早产儿。研究对象按出院时的喂养方式分为3组：纯母乳喂养组（组1）、混合喂养组（组2）以及纯人工配方奶喂养组（组3）。本研究计算了各组的构成比，同时统计了体重、身长及头围的平均Z评分差值。本研究共纳入649例新生儿。组1、组2、组3的平均出生体重分别为1338.7g、1104.0g及1254.7g，平均胎龄分别为31.9周、30周及31.2周。三组的Z评分差值（均值±标准差）分别为：体重方面：组1为-0.84±0.68，组2为-1.02±0.75，组3为-0.86±0.71；头围方面：组1为-0.21±1.23，组2为-0.52±1.64，组3为-0.08±1.34；身长方面：组1为-1.10±1.18，组2为-1.54±1.37，组3为-0.97±1.21。在校正后的身长Z评分模型中，组2与组3之间存在显著差异；其余人体测量学指标的组间比较均无统计学差异。鉴于母乳喂养具备多重优势，且不同喂养方式对早产儿营养状况无显著影响，因此新生儿病房应积极鼓励母乳喂养。