Impact of early human milk on sepsis and health-care costs in very low birth weight infants.
J Perinatol
; 33(7): 514-9, 2013 Jul.
Article
in En
| MEDLINE
| ID: mdl-23370606
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. STUDYDESIGN:
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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Sepsis
/
Infant, Very Low Birth Weight
/
Infant, Premature, Diseases
/
Milk, Human
Type of study:
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Female
/
Humans
/
Male
/
Newborn
Language:
En
Journal:
J Perinatol
Journal subject:
PERINATOLOGIA
Year:
2013
Document type:
Article
Affiliation country:
Estados Unidos