Does Breastmilk Influence the Development of Bronchopulmonary Dysplasia? - 23/01/16

Doi : 10.1016/j.jpeds.2015.10.080

Juliane Spiegler, MD ^1,^⁎ , Michael Preuß, PhD ², Corinna Gebauer, MD ³, Meike Bendiks, MD ¹, Egbert Herting, PhD ¹, Wolfgang Göpel, MD ¹
on behalf of the
German Neonatal Network (GNN)^{^∗}
List of GNN study group members is available at www.jpeds.com (Appendix).
Meike Bendiks, MD, Martin A. Berghäuser, MD, Kai Böckenholt, MD, Bettina Bohnhorst : Prof, Ralf Böttger, MD, Thomas Brune : Prof, Kristin Dawczynski, MD, Michael Dördelmann, MD, Silke Ehlers, MD, Joachim G. Eichhorn, MD, Ursula Felderhoff-Müser : Prof, Axel Franz, MD, Corinna Gebauer, MD, Hubert Gerleve, MD, Wolfgang Göpel : Prof, Ludwig Gortner : Prof, Roland Haase, MD, Friedhelm Heitmann, MD, Roland Hentschel : Prof, Nico Hepping, MD, Georg Hillebrand, MD, Thomas Höhn : Prof, Isabelle Hörnig-Franz, MD, Mechthild Hubert, MD, Andreas Jenke, MD, Rainer Jensen, MD, Olaf Kannt, MD, Hans T. Körner, MD, Angela Kribs, MD, Helmut Küster, MD, Knud Linnemann, MD, Jens Möller : Prof, Andreas Müller : Prof, Dirk Müller, MD, Dirk M. Olbertz, MD, Thorsten Orlikowsky : Prof, Jochen Reese, MD, Claudia Roll : Prof, Rainer Rossi : Prof, Mario Rüdiger : Prof, Thomas Schaible, MD, Jan-Holger Schiffmann : Prof, Susanne Schmidkte, MD, Stephan Seeliger, MD, Hugo Segerer : Prof, Jens Siegel, MD, Norbert Teig, MD, Florian Urlichs, MD, Axel von der Wense, MD, Matthias Vochem, MD, Ursula Weller, MD, Christian Wieg, MD, Jürgen Wintgens, MD

¹ Department of Pediatrics, University of Lübeck, Lübeck, Germany
² Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
³ Department of Pediatrics, University of Leipzig, Leipzig, Germany

^∗Reprint requests: Juliane Spiegler, MD, Department of Pediatrics, University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany.

Abstract

Objective

To assess whether breastmilk feeding is associated with a reduced risk of bronchopulmonary dysplasia (BPD). Secondary outcome measures analyzed were retinopathy of prematurity (ROP) and necrotizing enterocolitis (NEC).

Study design

In an ongoing multicenter cohort study, the data of 1433 very low birth weight infants born before 32 weeks of gestation and discharged in 2013 were analyzed. We compared growth and neonatal complications of infants who received breastmilk exclusively (N = 223) with those who received formula feedings exclusively (N = 239). Logistic regression models were estimated for BPD, ROP, and NEC using nutrition as an independent variable. The Firth logistic regression model and Lasso were used for sensitivity analyses.

Results

Exclusively breastmilk-fed infants gained less weight compared with formula-fed infants. SDS for weight decreased between birth and discharge (median (Q1-Q3): formula −0.9 (−1.4 to [−0.5]) vs breastmilk −1.1 (−1.7 to [−0.6])). Exclusive formula feeding of very low birth weight infants was associated with increased risks of BPD (OR 2.6) as well as NEC (OR 12.6) and ROP (OR 1.80) after controlling for known risk factors.

Conclusions

Exclusive breastmilk feeding was associated with lower growth rates and a reduced risk of BPD as well as NEC and ROP.

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Keyword : BPD, CRIB, IVH, NEC, ROP, VLBW

Plan

GNN is funded by the German Ministry for Education and Research (01ER0805 and 01ER1501). The authors declare no conflicts of interest.

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Does Breastmilk Influence the Development of Bronchopulmonary Dysplasia? - 23/01/16

Abstract

Objective

Study design

Results

Conclusions

Plan

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