Background Evidence is insufficient to show whether fortification has any effect on growth in preterm infants after discharge. Objective to verify whether VLBW preterm infants who are supplemented with multicomponent present greater anthropometric measurements than those not supplemented. Study Design Parallel randomized controlled trial. A computer-generated random number table was used to allocate the participants. Participants Preterm infants discharged from the NICU of a University Hospital from northeast, Brazil, weighing less than 1,500 g exclusively breastfed at discharge and followed up until they reached 6 months corrected gestational age. Intervention intervention group received Nestlé® PreNan® formula, fractionated in 2 g of powder, mixed with the mother's milk twice a day. Control group was exclusively breastfed. Follow-up was conducted until the infants reached 6 months corrected gestational age (CGA). Outcomes Growth of the anthropometrics parameters weight, head circumference (HC) and lenth with 6 months of corrected age. Mixed effects model for longitudinal data was used. Interaction according to sex was detected and ajusted. Results Weight gain was significantly higher in the intervention group. This effect was verified only for males (p = 0.001). No statistically significant association was observed between the intervention and the head circumference or length (p = 0.211; 0.597). The weaning rate at the end of follow-up was similar in both groups. Conclusions Breastmilk supplementation may improve the weight gain of very low birthweight preterm infants up to six months corrected gestational age. This effect differed by sex and was considered significant only for males.
OBJETIVO: identificar os casos de morbidade neonatal near miss em um serviço de Perinatologia do estado do Maranhão. MÉTODO: pesquisa descritiva e transversal de abordagem quantitativa, realizada a partir da análise dos dados de recém-nascidos internados na Unidade Neonatal de um Serviço de Perinatologia no período de 2017 a 2018. As análises estatísticas foram processadas no programa estatístico STATA versão 14.0. RESULTADOS: o peso ao nascer <1500g foi a variável que mais classificou casos de near miss neonatal, seguido pela variável de idade gestacional <34 semanas. Os resultados obtidos demonstraram associação entre hipertensão gestacional e peso ao nascer; hipertensão gestacional e idade gestacional ao nascer; parto cesáreo e Apgar no 5º minuto ≥ 7; parto cesáreo e sexo masculino. CONCLUSÃO: observou-se a importância da abordagem near miss neonatal para a compreensão ampliada da morbimortalidade neonatal e fatores associados.
Background:
Breastfeeding maintains the maternal-fetal immune link after birth, favors
the transmission of immunological competence, and is considered an important contributing factor
to the development of the babies’ immune system.
Objective:
This study aimed to obtain data related to the effects of gestational diabetes on immunoglobulin
A (IgA) and cytokines levels in the colostrum, before and during the pandemic of the
new coronavirus, in order to study the possible outcomes regarding the immunological characteristics
of human milk.
Methods:
This systematic review was registered in PROSPERO CRD42020212397, and the question
elaborated using the PICO strategy was: does maternal hyperglycemia associated or not with
Covid-19 influence the immunological composition of colostrum? Electronic searching and reference
lists of published reports were used to identify studies that reported the influence of gestational
diabetes on colostrum and milk composition.
Results:
Seven studies were selected from the 51 found, six of them were cross-sectional and one
was a case report. Six studies included Brazilian groups and only one was conducted in USA. The
mothers with gestational diabetes presented a reduced level of IgA and other immunoreactive proteins
in colostrum. Those alterations could be related to changes in macronutrient metabolism and
cellular oxidative metabolism.
Conclusions:
It was possible to conclude that diabetes changes the immunological composition of
breast milk; however, data on the impact of the association between gestational diabetes and
Covid-19 infection on the composition of antibodies and cytokines present in human milk are still
scarce and inconclusive.
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