Does Fetal Growth Adequacy Affect the Nutritional Composition of Mothers' Milk?: A Historical Cohort Study

被引：3

作者：

Correia, Lia ^{[1
]}

Cardoso, Manuela ^{[1
,2
]}

Luisa Papoila, Ana ^{[3
]}

Alves, Marta ^{[3
]}

Virella, Daniel ^{[3
,4
]}

Ramalho, Renata ^{[1
]}

Pereira, Paula ^{[1
]}

Macedo, Israel ^{[5
]}

Tome, Teresa ^{[5
]}

Cohen, Alvaro ^{[6
]}

Pereira-da-Silva, Luis ^{[4
,7
]}

机构：

[1] Inst Univ Egas Moniz, Ctr Invest Interdisciplinar Egas Moniz CiiEM, Egas Moniz Higher Educ Sch, Appl Nutr Studies Grp GENA IUEM,U4585 FCT, Monte De Caparica, Portugal

[2] Ctr Hosp Univ Lisboa Cent, Nutr Unit, Maternidade Dr Alfredo Costa, Lisbon, Portugal

[3] Ctr Hosp Univ Lisboa Cent, Res Unit, Lisbon, Portugal

[4] Ctr Hosp Univ Lisboa Cent, Hosp Dona Estefania, Neonatal Intens Care Unit, Lisbon, Portugal

[5] Ctr Hosp Univ Lisboa Cent, Neonatal Intens Care Unit, Maternidade Dr Alfredo Costa, Lisbon, Portugal

[6] Ctr Hosp Univ Lisboa Cent, Maternidade Dr Alfredo Costa, Prenatal Diag, Lisbon, Portugal

[7] Univ Nova Lisboa, NOVA Med Sch,Fac Ciencias Med, Comprehens Hlth Res Ctr, Med Woman Children & Adolescent, Lisbon, Portugal

来源：

AMERICAN JOURNAL OF PERINATOLOGY | 2023年 / 40卷 / 02期

关键词：

fetal growth restriction; maternal hypertension; mothers' milk composition; prematurity; twin pregnancy; FOR-GESTATIONAL-AGE; PRETERM INFANTS; NUTRIENT CONTENT; FATTY-ACIDS; FORTIFICATION; BIRTH; MACRONUTRIENT; EPIDEMIOLOGY; METAANALYSIS; APPROPRIATE;

D O I：

10.1055/s-0041-1727278

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective The study aimed to assess the association between intrauterine growth of preterm infants and energy and macronutrient contents in their mothers' milk. Study Design A historical cohort of mothers of preterm infants was assessed according to offspring's intrauterine growth. Fetal growth restriction (FGR) was defined as small-for-gestational age or appropriate for gestational age with fetal growth deceleration. During the first 4 weeks after delivery, the composition of daily pool samples of mothers' milk was measured by using a mid-infrared human milk analyzer. Explanatory models for milk energy, true protein, total carbohydrate, and fat contents were obtained by generalized additive mixed effects regression models. Results In total, 127 milk samples were analyzed from 73 mothers who delivered 92 neonates. Energy content was significantly higher in mothers with chronic hypertension (average: +6.28 kcal/dL; 95% confidence interval [CI]: 0.54-12.01; p = 0.034) and for extremely preterm compared with very preterm infants (average: +5.95 kcal/dL; 95% CI: 2.16-9.73; p = 0.003), and weakly associated with single pregnancies (average: +3.38 kcal/dL; 95% CI: 0.07-6.83; p = 0.057). True protein content was significantly higher in mothers with chronic hypertension (average: +0.91 g/dL; 95% CI: 0.63-1.19; p < 0.001) and with hypertension induced by pregnancy (average: +0.25 g/dL, 95% CI: 0.07-0.44; p = 0.007), and for extremely preterm compared with very and moderate preterm infants (average: +0.19; 95% CI: 0.01-0.38; p = 0.043 and +0.28 g/dL; 95% CI: 0.05-0.51; p = 0.017, respectively). Fat content was weakly and negatively associated with FGR, both in SGA infants and AGA infants with fetal growth deceleration (average: -0.44 g/dL; 95% CI: -0.92 to -0.05; p = 0.079 and average: -0.36 g/dL; 95% CI: -0.74 to -0.02; p = 0.066, respectively). Conclusion Energy and macronutrient contents in mothers' milk of preterm infants was significantly and positively associated with the degree of prematurity and hypertension. The hypothesis that the composition of milk is associated with FGR was not demonstrated.

引用

页码：163 / 171

页数：9

共 55 条

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