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Comparative study of preterm infants fed new and existing human milk fortifiers showed favourable markers of gastrointestinal status.
Acta Paediatr. 2020 03; 109(3):527-533.AP

Abstract

AIM

This study examined the influence of different human milk fortifiers on biomarkers of gastrointestinal immaturity and inflammation in preterm infants.

METHODS

We report secondary outcomes from a controlled, double-blind, randomised, parallel group study conducted from 2011 to 2014 in neonatal intensive care units at 11 metropolitan hospitals in France, Belgium, Germany, Switzerland and Italy. Preterm infants born at up to 32 weeks or weighing up to 1500 g were randomised to a new powdered human milk fortifier (n = 77) or a control fortifier (n = 76) for a minimum of 21 days. We analysed faecal markers of gut inflammation, namely alpha-1 antitrypsin and calprotectin, and maturity, namely elastase-1.

RESULTS

Faecal alpha-1 antitrypsin was slightly lower in the new than control fortifier group after 21 days of full enteral feeding, with a geometric mean and standard deviation of 1.52 ± 1.32 vs 1.82 ± 1.44 mg/g stools (P = .01). There was no significant difference in faecal calprotectin (median [Q1-Q3] of 296 [136-565] μg/g stools in both groups combined at study day 21). Faecal elastase-1 was lower in the new fortifier than control fortifier group (202.5 ± 1.6 vs 257.7 ± 1.5 μg/g stools, P = .016).

CONCLUSION

Mean values for each parameter were within the ranges in healthy term infants, indicating favourable markers of gastrointestinal status in both groups. In addition, for faecal calprotectin, the relatively high concentration observed in preterm infants fed fortified human milk suggests that the threshold level for detecting necrotising enterocolitis should be revised.

Authors+Show Affiliations

Department of Neonatology, CHR Citadelle, University of Liège, Liège, Belgium.Maternité Régionale Universitaire A. Pinard, CHRU, Nancy, France.Service de Neonatologie, Hôpital de la Croix Rousse, Lyon, France.Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, Fondazione IRCCS "Ca' Granda" Ospedale Maggiore Policlinico, University of Milan, Milano, Italy.Hôpital Couple Enfant, CHU de Grenoble, Grenoble, France.Hôpital Clocheville, CHU de Tours, Tours, France.Klinikum Westbrandenburg GmbH, Potsdam, Germany.Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.Hôpital Clemenceau, CHU de Caen, Caen, France.Nestlé Product Technology Center - Nutrition, La Tour-de-Peilz, Switzerland.Nestlé Clinical Development Unit, Lausanne, Switzerland.CIC Pédiatrique 1401 CHU, Bordeaux, France.Children's Hospital of Lucerne, Lucerne, Switzerland.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31435957

Citation

Rigo, Jacques, et al. "Comparative Study of Preterm Infants Fed New and Existing Human Milk Fortifiers Showed Favourable Markers of Gastrointestinal Status." Acta Paediatrica (Oslo, Norway : 1992), vol. 109, no. 3, 2020, pp. 527-533.
Rigo J, Hascoët JM, Picaud JC, et al. Comparative study of preterm infants fed new and existing human milk fortifiers showed favourable markers of gastrointestinal status. Acta Paediatr. 2020;109(3):527-533.
Rigo, J., Hascoët, J. M., Picaud, J. C., Mosca, F., Rubio, A., Saliba, E., Radkë, M., Simeoni, U., Guillois, B., Hays, N. P., Hartweg, M., Billeaud, C., & Spalinger, J. (2020). Comparative study of preterm infants fed new and existing human milk fortifiers showed favourable markers of gastrointestinal status. Acta Paediatrica (Oslo, Norway : 1992), 109(3), 527-533. https://doi.org/10.1111/apa.14981
Rigo J, et al. Comparative Study of Preterm Infants Fed New and Existing Human Milk Fortifiers Showed Favourable Markers of Gastrointestinal Status. Acta Paediatr. 2020;109(3):527-533. PubMed PMID: 31435957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative study of preterm infants fed new and existing human milk fortifiers showed favourable markers of gastrointestinal status. AU - Rigo,Jacques, AU - Hascoët,Jean-Michel, AU - Picaud,Jean-Charles, AU - Mosca,Fabio, AU - Rubio,Amandine, AU - Saliba,Elie, AU - Radkë,Michaël, AU - Simeoni,Umberto, AU - Guillois,Bernard, AU - Hays,Nicholas P, AU - Hartweg,Mickaël, AU - Billeaud,Claude, AU - Spalinger,Johannes, Y1 - 2019/09/30/ PY - 2019/04/17/received PY - 2019/08/20/accepted PY - 2019/8/23/pubmed PY - 2019/8/23/medline PY - 2019/8/23/entrez KW - alpha-1 antitrypsin KW - calprotectin KW - elastase-1 KW - low birthweight infant KW - prematurity SP - 527 EP - 533 JF - Acta paediatrica (Oslo, Norway : 1992) JO - Acta Paediatr. VL - 109 IS - 3 N2 - AIM: This study examined the influence of different human milk fortifiers on biomarkers of gastrointestinal immaturity and inflammation in preterm infants. METHODS: We report secondary outcomes from a controlled, double-blind, randomised, parallel group study conducted from 2011 to 2014 in neonatal intensive care units at 11 metropolitan hospitals in France, Belgium, Germany, Switzerland and Italy. Preterm infants born at up to 32 weeks or weighing up to 1500 g were randomised to a new powdered human milk fortifier (n = 77) or a control fortifier (n = 76) for a minimum of 21 days. We analysed faecal markers of gut inflammation, namely alpha-1 antitrypsin and calprotectin, and maturity, namely elastase-1. RESULTS: Faecal alpha-1 antitrypsin was slightly lower in the new than control fortifier group after 21 days of full enteral feeding, with a geometric mean and standard deviation of 1.52 ± 1.32 vs 1.82 ± 1.44 mg/g stools (P = .01). There was no significant difference in faecal calprotectin (median [Q1-Q3] of 296 [136-565] μg/g stools in both groups combined at study day 21). Faecal elastase-1 was lower in the new fortifier than control fortifier group (202.5 ± 1.6 vs 257.7 ± 1.5 μg/g stools, P = .016). CONCLUSION: Mean values for each parameter were within the ranges in healthy term infants, indicating favourable markers of gastrointestinal status in both groups. In addition, for faecal calprotectin, the relatively high concentration observed in preterm infants fed fortified human milk suggests that the threshold level for detecting necrotising enterocolitis should be revised. SN - 1651-2227 UR - https://www.unboundmedicine.com/medline/citation/31435957/Comparative_study_of_preterm_infants_fed_new_and_existing_human_milk_fortifiers_showed_favourable_markers_of_gastrointestinal_status L2 - https://doi.org/10.1111/apa.14981 DB - PRIME DP - Unbound Medicine ER -
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