不同的胃食管反流特征的早产儿喂养母乳与配方奶粉：洞察临床实践的结果。

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-09-17 DOI:10.1038/s41372-025-02421-y

Erika K Osborn, Zakia Sultana, Faith Bala, Enas Alshaikh, Sudarshan R Jadcherla

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引用次数: 0

摘要

目的：比较母乳喂养和配方奶粉喂养的婴儿胃食管反流（GERD）的特征和临床结果。方法：316例（孕30.1±3.4周）早产儿于经后39.8±1.4周进行24 h ph阻抗检测。比较了母乳喂养和配方奶粉喂养婴儿的GER特征、短期和长期结果。结果：母乳喂养的婴儿（与配方奶喂养的相比）在症状、胃酸清除率、大剂量清除率、远端基线阻抗和排泄结果方面具有更高的胃酸反流指数（ARI），胃酸反流事件数量增加，胃酸事件时间延长，近端胃酸暴露程度更高（p0.05）。结论：尽管酸- ger事件会引起病理生理反应，但母乳的特性可能对食管刺激下的神经感觉和神经运动反应提供更好的适应和调节。

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Distinct gastroesophageal reflux characteristics in preterm-born infants fed human milk versus formula: insights for clinical practice on outcomes.

Objective: To compare the characteristics of gastroesophageal reflux (GER) and clinical outcomes among human milk-fed vs. formula-fed infants evaluated for GER disease (GERD).

Methods: Preterm-born infants (N = 316, 30.1 ± 3.4 weeks gestation) referred for 24-h pH-impedance testing at 39.8 ± 1.4 weeks postmenstrual age. GER characteristics, short- and long-term outcomes were compared between the human milk- vs. formula-fed infants.

Results: Human milk-fed infants (vs. formula-fed) had a greater acid reflux index (ARI), and an increased number of acid reflux events, prolonged acid events, and greater proximal acid exposure (P < 0.05). There were no differences (P > 0.05) in symptoms, acid clearance, bolus clearance, distal baseline impedance, and discharge outcomes. Bayley composite scores at 2 years were distinct (P < 0.05) for the distribution (%) of receptive and fine motor skills, favoring human milk-fed infants.

Conclusions: Despite the pathophysiology caused by acid-GER events, human milk properties may provide better adaptation and modulation of neurosensory and neuromotor responses upon esophageal provocation.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.