Effect of breastfeeding on the development of infection-related diseases during hospitalization in late preterm infants in 25 hospitals in Beijing, China
HAN Lu-Yan1, XU Xiao-Jing1, TONG Xiao-Mei2, ZHANG Xin3, LIU Jie4, YANG Li5, LIU Hui6, YAN Ju7, SONG Zhi-Fang8, MEI Ya-Bo9, MI Rong10, QIN Xuan-Guang11, LIU Yu-Huan12, QI Yu-Jie13, ZHANG Wei14, ZENG Hui-Hui14, CUI Hong15, LONG Hui16, GUO Guo17, CHEN Xu-Lin18, YANG Zhao-Yi19, SUN Fang20, FU Xiao-Hui21, WANG Chang-Yan22, LI Zheng-Hong22
Department of Pediatrics, First Hospital of Tsinghua University, Beijing 100016, China
Abstract:Objective To investigate the incidence rate of infectious diseases during hospitalization in late preterm infants in Beijing, China, as well as the risk factors for infectious diseases and the effect of breastfeeding on the development of infectious diseases. Methods Related data were collected from the late preterm infants who were hospitalized in the neonatal wards of 25 hospitals in Beijing, China, from October 23, 2015 to October 30, 2017. According to the feeding pattern, they were divided into a breastfeeding group and a formula feeding group. The two groups were compared in terms of general status and incidence rate of infectious diseases. A multivariate logistic regression analysis was used to investigate the risk factors for infectious diseases. Results A total of 1 576 late preterm infants were enrolled, with 153 infants in the breastfeeding group and 1 423 in the formula feeding group. Of all infants, 484 (30.71%) experienced infectious diseases. The breastfeeding group had a significantly lower incidence rate of infectious diseases than the formula feeding group (22.88% vs 31.55%, P=0.033). The multivariate logistic regression analysis showed that breastfeeding was an independent protective factor against infectious diseases (OR=0.534, P=0.004), while male sex, premature rupture of membranes, gestational diabetes mellitus, and asphyxia were risk factors for infectious diseases (OR=1.328, 5.386, 1.535, and 2.353 respectively, P < 0.05). Conclusions Breastfeeding can significantly reduce the incidence of infectious diseases and is a protective factor against infectious diseases in late preterm infants. Breastfeeding should therefore be actively promoted for late preterm infants during hospitalization.
HAN Lu-Yan,XU Xiao-Jing,TONG Xiao-Mei et al. Effect of breastfeeding on the development of infection-related diseases during hospitalization in late preterm infants in 25 hospitals in Beijing, China[J]. CJCP, 2020, 22(12): 1245-1250.
Morgan JC, Boyle EM. The late preterm infant[J]. Paediatr Child Health (Oxford), 2018, 28(1):13-17.
[2]
García-Reymundo M, Demestre X, Calvo MJ, et al. Late preterm infants in Spain:experience of the 34-36 neonatal group[J]. An Pediatr (Barc), 2018, 88(5):246-252.
[3]
Visruthan NK, Agarwal P, Sriram B, et al. Neonatal outcome of the late preterm infant (34 to 36 weeks):the Singapore story[J]. Ann Acad Med Singap, 2015, 44(7):235-243.
[4]
King JP, Gazmararian JA, Shapiro-Mendoza CK. Disparities in mortality rates among US infants born late preterm or early term, 2003-2005[J]. Matern Child Health J, 2014, 18(1):233-241.
[5]
Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, et al. Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk[J]. Pediatrics, 2008, 121(2):e223-e232.
[6]
Richards JL, Kramer MS, Deb-Rinker P, et al. Temporal trends in late preterm and early term birth rates in 6 high-income countries in North America and Europe and association with clinician-initiated obstetric interventions[J]. JAMA, 2016, 316(4):410-419.
[7]
Mally PV, Bailey S, Hendricks-Muñoz KD. Clinical issues in the management of late preterm infants[J]. Curr Probl Pediatr Adolesc Health Care, 2010, 40(9):218-233.
Kugelman A, Colin AA. Late preterm infants:near term but still in a critical developmental time period[J]. Pediatrics, 2013, 132(4):741-751.
[11]
Williams JE, Pugh Y. The late preterm:a population at risk[J]. Crit Care Nurs Clin North Am, 2018, 30(4):431-443.
[12]
Natarajan G, Shankaran S. Short- and long-term outcomes of moderate and late preterm infants[J]. Am J Perinatol, 2016, 33(3):305-317.
[13]
Mally PV, Hendricks-Muñoz KD, Bailey S. Incidence and etiology of late preterm admissions to the neonatal intensive care unit and its associated respiratory morbidities when compared to term infants[J]. Am J Perinatol, 2013, 30(5):425-431.
[14]
Snyers D, Lefebvre C, Viellevoye R, et al. Late preterm:high risk newborns despite appearances[J]. Rev Med Liege, 2020, 75(2):105-110.
[15]
Cohen-Wolkowiez M, Moran C, Benjamin DK, et al. Early and late onset sepsis in late preterm infants[J]. Pediatr Infect Dis J, 2009, 28(12):1052-1056.
[16]
Giannì ML, Bezze E, Sannino P, et al. Facilitators and barriers of breastfeeding late preterm infants according to mothers' experiences[J]. BMC Pediatr, 2016, 16(1):179.
[17]
Adamkin DH. Feeding problems in the late preterm infant[J]. Clin Perinatol, 2006, 33(4):831-837.
Lapillonne A, Bronsky J, Campoy C, et al. Feeding the late and moderately preterm infant:a position paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition[J]. J Pediatr Gastroenterol Nutr, 2019, 69(2):259-270.
[20]
Cortez J, Makker K, Kraemer DF, et al. Maternal milk feedings reduce sepsis, necrotizing enterocolitis and improve outcomes of premature infants[J]. J Perinatol, 2018, 38(1):71-74.
[21]
Sullivan S, Schanler RJ, Kim JH, et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products[J]. J Pediatr, 2010, 156(4):562-567.e1.
[22]
Goyal NK, Attanasio LB, Kozhimannil KB. Hospital care and early breastfeeding outcomes among late preterm, early-term, and term infants[J]. Birth, 2014, 41(4):330-338.
[23]
Estalella I, San Millán J, Trincado MJ, et al. Evaluation of an intervention supporting breastfeeding among late-preterm infants during in-hospital stay[J]. Women Birth, 2020, 33(1):e33-e38.
[24]
Asadi S, Bloomfield FH, Harding JE. Nutrition in late preterm infants[J]. Semin Perinatol, 2019, 43(7):151160.