Journal of pediatric gastroenterology and nutrition · 2025
Clinical outcomes related to human milk fortification in preterm infants postdischarge-A nonrandomized interventional trial.
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Haribalakrishna Anitha, Kirthana S B, Sahu Namita, Nerurkar Omkar, Raghavendra Prashanth
Аннотация
OBJECTIVES: We studied the effects of postdischarge fortification of human milk in stable, very low birth weight (VLBW) infants.
METHODS: VLBW infants under 37 weeks of gestation were allocated before discharge to either a postdischarge fortification group (fortification continued till 1.8 kg) or a control group (fortification stopped at discharge). The primary outcome studied was weight gain per day from birth until 40 weeks postmenstrual age. Other outcomes studied were gain in length and head circumference (HC) per week, feed intolerance, mortality, anemia of prematurity, retinopathy of prematurity, osteopenia of prematurity, and bronchopulmonary dysplasia.
RESULTS: One hundred and twenty-six infants were enrolled (63 in the fortification group and 63 in the control group). The primary outcome of weight gain per day (17.7 vs. 13.9 g, p = 0.001) was significantly greater in the fortification group. Length gain (0.77 vs. 0.76 cm, p = 0.04) and HC gain per week (0.61 vs. 0.60 cm, p = 0.03) were significantly greater in the fortification group. The median difference between the two groups, for the Z-score change from birth to 40 weeks for weight (2.96 [1.39, 2.09]), length (2.33 [2.08, 3.03]), and HC (2.64 [1.77, 2.99]) and from discharge to 40 weeks postmenstrual age for weight (2.74 [2.49, 3.09]), length (2.42 [-0.39, 4.34]), and HC (2.08 [1.71, 2.52]) was significantly higher in the fortification group (p < 0.0001). Other secondary outcomes were similar between the groups.
CONCLUSION: In preterm VLBW infants, postdischarge fortification of human milk was associated with greater gain in weight, length, and HC till they reached term gestation.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: CTRI/2024/07/069958.
METHODS: VLBW infants under 37 weeks of gestation were allocated before discharge to either a postdischarge fortification group (fortification continued till 1.8 kg) or a control group (fortification stopped at discharge). The primary outcome studied was weight gain per day from birth until 40 weeks postmenstrual age. Other outcomes studied were gain in length and head circumference (HC) per week, feed intolerance, mortality, anemia of prematurity, retinopathy of prematurity, osteopenia of prematurity, and bronchopulmonary dysplasia.
RESULTS: One hundred and twenty-six infants were enrolled (63 in the fortification group and 63 in the control group). The primary outcome of weight gain per day (17.7 vs. 13.9 g, p = 0.001) was significantly greater in the fortification group. Length gain (0.77 vs. 0.76 cm, p = 0.04) and HC gain per week (0.61 vs. 0.60 cm, p = 0.03) were significantly greater in the fortification group. The median difference between the two groups, for the Z-score change from birth to 40 weeks for weight (2.96 [1.39, 2.09]), length (2.33 [2.08, 3.03]), and HC (2.64 [1.77, 2.99]) and from discharge to 40 weeks postmenstrual age for weight (2.74 [2.49, 3.09]), length (2.42 [-0.39, 4.34]), and HC (2.08 [1.71, 2.52]) was significantly higher in the fortification group (p < 0.0001). Other secondary outcomes were similar between the groups.
CONCLUSION: In preterm VLBW infants, postdischarge fortification of human milk was associated with greater gain in weight, length, and HC till they reached term gestation.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: CTRI/2024/07/069958.