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J Perinatol. 2013 Jul;33(7):514-9. doi: 10.1038/jp.2013.2. Epub 2013 Jan 31.

Impact of early human milk on sepsis and health-care costs in very low birth weight infants.

Author information

1
Department of Pediatrics, Rush University Medical Center, Chicago, IL 60612, USA. Aloka_Patel@Rush.edu

Abstract

OBJECTIVE:

To study the incidence of sepsis and neonatal intensive care unit (NICU) costs as a function of the human milk (HM) dose received during the first 28 days post birth for very low birth weight (VLBW) infants.

STUDY DESIGN:

Prospective cohort study of 175 VLBW infants. The average daily dose of HM (ADDHM) was calculated from daily nutritional data for the first 28 days post birth (ADDHM-Days 1-28). Other covariates associated with sepsis were used to create a propensity score, combining multiple risk factors into a single metric.

RESULT:

The mean gestational age and birth weight were 28.1 ± 2.4 weeks and 1087 ± 252 g, respectively. The mean ADDHM-Days 1-28 was 54 ± 39 ml kg(-1) day(-1) (range 0-135). Binary logistic regression analysis controlling for propensity score revealed that increasing ADDHM-Days 1-28 was associated with lower odds of sepsis (odds ratio 0.981, 95% confidence interval 0.967-0.995, P=0.008). Increasing ADDHM-Days 1-28 was associated with significantly lower NICU costs.

CONCLUSION:

A dose-response relationship was demonstrated between ADDHM-Days 1-28 and a reduction in the odds of sepsis and associated NICU costs after controlling for propensity score. For every HM dose increase of 10 ml kg(-1) day(-1), the odds of sepsis decreased by 19%. NICU costs were lowest in the VLBW infants who received the highest ADDHM-Days 1-28.

PMID:
23370606
PMCID:
PMC3644388
DOI:
10.1038/jp.2013.2
[Indexed for MEDLINE]
Free PMC Article

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