摘要
目的评估出生体质量<1 500 g的低出生体质量儿直接喂哺巨细胞病毒(CMV)DNA阳性亲母乳汁的安全性。方法选择2015年5月1日—2015年12月31日以及2016年5月1日—2016年12月31日期间住院的出生体质量<1 500 g的低出生体质量儿为研究对象,所有研究对象住院期间均首选亲母的母乳喂养,亲母母乳量不足时,以捐献母乳补充。生后2周左右荧光定量聚合酶链式反应(FQ-PCR)检测亲母乳汁CMV DNA含量。如亲母乳汁CMV DNA阳性,2015年5月1日—2015年12月31日期间乳汁经巴氏消毒后喂养,2016年5月1日—2016年12月31日期间乳汁不处理直接喂养。分别比较乳汁阳性直接喂养组、乳汁阳性巴氏消毒组、乳汁阴性组的感染、肝损伤、听力损伤的差异。结果共纳入222例出生体质量<1 500 g的低出生体质量儿,其中21例出生体质量<1 000 g。亲母乳汁CMV DNA检测阳性132例(59.46%),其中乳汁阳性直接喂养组67例、乳汁阳性巴氏消毒组65例、乳汁阴性组90例。三组胎龄、出生体质量、性别等差异无统计学意义(P均>0.05),三组住院期间新生儿肺炎、晚发性败血症、肠道感染、肝损害、听力损伤发生率的差异也无统计学意义(P均>0.05)。结论直接喂养CMV DNA阳性的亲母乳汁,未增加低出生体质量儿住院期间的不良临床结局。
Objective To evaluate the safety of cytomegalovirus(CMV) DNA positive fresh breast milk in low birth weight infants(< 1500 g). Methods The low birth weight infants(< 1500 g) admitted to hospital were enrolled from May 1, 2015 to Dec. 31, 2015 and from May 1, 2016 to Dec. 31, 2016. All the subjects were breast fed by own mother's milk during the period of hospitalization, and was supplemented with the donated breast milk when the mothers' breast milk was insufficient. The CMV DNA content in mother's milk was measured by quantitative polymerase chain reaction(FQ-PCR) at two weeks after birth. If the CMV DNA in mother's milk was positive, during the period of May 1, 2015 to Dec 31, 2015, the milk was pasteurized before fed; during the period of May 1, 2016 to Dec. 31, 2016, the milk was fed without treatment. The differences of infections, liver injury, and hearing impairment among the untreated CMV DNA positive milk group, the pasteurized CMV DNA positive milk group, the untreated CMV DNA negative milk group were compared. Results A total of 222 low birth weight infants(<1500 g) were included, among whom 21 infants had birth weight < 1000 g. The CMV DNA was detected positive in 132(59.46%) mother's milk. Sixty-seven infants were in the untreated CMV DNA positive milk group, 65 infants in the pasteurized CMV DNA positive milk group, and 90 infants in untreated CMV DNA negative group milk group. There were no significantly differences in gestational age, birth weight and sex among three groups. There were also no significant differences in the incidence of neonatal pneumonia, late sepsis, intestinal infection, liver damage, and hearing loss among three groups(P>0.05). Conclusions Feeding CMV DNA positive mother's breast milk does not adversely affect the clinical outcomes in low birth weight infants during hospitalization.
出处
《临床儿科杂志》
CSCD
北大核心
2017年第12期923-927,共5页
Journal of Clinical Pediatrics
基金
南京市医学科技发展基金项目(No.ZKX16062)
关键词
母乳
巨细胞病毒
低出生体质量儿
breast milk
cytomegalovirus
low birth weight infant
