Study on the effect of milk feeding on the incidence of retinopathy of prematurity_Chinese Journal of Ocular Fundus Diseases

Authors：

 Liu Delin , Zheng Jiao , Men Guangguo , Xu Minjuan

Ningbo Women's and Children's Hospital, Ningbo 315012, China;

Corresponding?author：

Liu Delin, Email: ldlxyyldl@163.com

Keywords：

Breast feeding; Retinopathy of prematurity; Infant, premature

DOI：

10.3760/cma.j.cn511434-20200930-00480

Video：

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Objective To observe the effect of breastfeeding on the incidence of retinopathy of prematurity (ROP).Methods A retrospective clinical study. From June 2017 to December 2019, 1256 eyes of 628 premature infants who were born in Ningbo Women and Children's Hospital and were screened for ROP were included in the study. Among them, there were in 325 males (650 eyes) and 303 females (606 eyes). According to the feeding situation, premature infants were divided into breastfeeding (research) group and formula feeding (control) group, with 390 cases of 780 eyes and 238 cases of 476 eyes, respectively. The changes in the retina of the fundus of the two groups of premature infants during the observation period were compared. The qualitative data comparison between groups was performed by the χ² test; the quantitative data comparison was performed by the two independent sample t test.Results The sex ratio of premature infants in the study group and control group (χ²=0.217), birth weight (t=0.728), gestational age at birth (t=0.351), Apgar score at birth (t=0.816), oxygen inhalation time (t=0.427), were compared with the length of stay in the neonatal intensive care unit (t=1.580), the difference was not statistically significant (P＞0.05). Among the 390 cases in the study group, 108 cases (27.7%, 108/390) and 282 cases (72.3%, 282/390) were with or without ROP, respectively; in the 238 cases in the control group, 86 (36.1%, 86/238) were with ROP, 152 (63.9%, 152/238) cases were without ROP. There was a statistically significant difference in the incidence of ROP between the two groups (χ²=4.934, P=0.026). Among the 108 cases of ROP in the study group, 50 (12.8%, 50/108), 35 (9.0%, 35/108), 23 (5.9%, 23/108) cases were in stage 1, 2 and 3, respectively. Among the 86 ROP cases in the control group, stages 1, 2 and 3 were 25 (10.5%, 25/86), 40 (16.8%, 40/86), and 21 (8.8%, 21/86), respectively. In the comparison of ROP staging between the two groups, the difference in stage 1 was not statistically significant (χ²=0.754, P＞0.05), and the difference in stage 2 and above was statistically significant (χ²=11.400, P＜0.05).Conclusion Breastfeeding may reduce the incidence and severity of ROP.

Citation： Liu Delin, Zheng Jiao, Men Guangguo, Xu Minjuan. Study on the effect of milk feeding on the incidence of retinopathy of prematurity. Chinese Journal of Ocular Fundus Diseases, 2021, 37(5): 348-351. doi: 10.3760/cma.j.cn511434-20200930-00480 Copy

1.	Yau GSK, Lee JWY, Tam VTY, et al. Incidence and risk factors for retinopathy of prematurity in extreme low birth weight Chinese infants[J]. Int Ophthalmol, 2015, 35(3): 365-373. DOI: 10.1007/s10792-014-9956-2.
2.	高琦, 張亞娟, 田秀英, 等. 母乳強化劑添加時間對極低出生體質量兒早期生長發育及并發癥發生率的影響[J]. 中華實用兒科臨床雜志, 2017, 32(7): 528-531. DOI: 10.3760/cma.j.issn.2095-428X.2017.07.014.Gao Q, Zhang YJ, Tian XY, et al. Effect of adding time of human milk fortifier on growth and incidence of complications of very low birth weight premature infants[J]. Chin J Appl Clin Pediatr, 2017, 32(7): 528-531. DOI: 10.3760/cma.j.issn.2095-428X.2017.07.014.
3.	Alpay A, U?urba? SH. Incidence and risk factors for retinopathy of prematurity in the West Black Sea region, Turkey[J]. Turk J Pediatr, 2012, 54(2): 113-118.
4.	中華醫學會眼科學分會眼底病學組. 中國早產兒視網膜病變篩查指南(2014年)[J]. 中華眼科雜志, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association. Guidelines for screening retinopathy of premature infants in China(2014)[J]. Chin J Ophthalmol, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.
5.	International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited[J]. Arch Ophthalmol, 2005, 123(7): 991-999. DOI: 10.1001/archopht.123.7.991.
6.	查汝勤, 王瓊, 劉輝. 安徽省婦幼保健院1041名早產兒或低體重兒早產兒視網膜病變篩查結果[J]. 中華眼底病雜志, 2019, 35(5): 496-497. DOI: 10.3760/cma.j.issn.1005-1015.2019.05.014.Zha RQ, Wang Q, Liu H. Screening results of retinopathy of premature infants in 1041 premature infants or low birth weight infants in Anhui Women and Child's Hospital[J]. Chin J Ocul Fundus Dis, 2019, 35(5): 496-497. DOI: 10.3760/cma.j.issn.1005-1015.2019.05.014.
7.	Bas AY, Koc E, Dilmen U, et al. Incidence and severity of retinopathy of prematurity in Turkey[J]. Br J Ophthalmol, 2015, 99(10): 1311-1314. DOI: 10.1136/bjophthalmol-2014-306286.
8.	Akyüz-ünsal A?, Key ?, Güler D, et al. Retinopathy of prematurity risk factors: does human milk prevent retinopathy of prematurity?[J]. Turk J Pediatr, 2019, 61(1): 13-19. DOI: 10.24953/turkjped.2019.01.003.
9.	高宏程, 陳晨, 張迎秋, 等. 早產兒視網膜病變的危險因素研究進展[J]. 國際眼科雜志, 2018, 18(1): 80-83. DOI: 10.3980/j.issn.1672-5123.2018.1.18.Gao HC, Chen C, Zhang YQ, et al. Research progress on risk factors of retinopathy of prematurity[J]. Int Eye Sci, 2018, 18(1): 80-83. DOI: 10.3980/j.issn.1672-5123.2018.1.18.
10.	祝巍, 王書蘭. 母乳喂養對早產兒視網膜病變的影響[J]. 中外女性健康研究, 2020, 3(6): 75-77.Zhe W, Wang SL. The effect of human milk feeding on retinopathy of prematurity[J]. Women's Health Research, 2020, 3(6): 75-77.
11.	Bharwani SK, Green BF, Pezzullo JC, et al. Systematic review and meta-analysis of human milk intake and retinopathy of prematurity: a significant update[J]. J Perinatol, 2016, 36(11): 913-920. DOI: 10.1038/jp.2016.98.
12.	Manzoni P, Stolfi I, Pedicino R, et al. Human milk feeding prevents retinopathy of prematurity (ROP) in preterm VLBW neonates[J]. Early Hum Dev, 2013, 89 Suppl 1: S64-68. DOI: 10.1016/S0378-3782(13)70019-7.
13.	Hylander MA, Strobino DM, Pezzullo JC, et al. Association of human milk feedings with a reduction in retinopathy of prematurity among very low birthweight infants[J]. J Perinatol, 2001, 21(6): 356-362. DOI: 10.1038/sj.jp.7210548.
14.	Zhou J, Shukla VV, John D, et al. Human milk feeding as a protective factor for retinopathy of prematurity: a meta-analysis[J/OL]. Pediatrics, 2015, 136(6): e1576-1586[2015-11-16]. https://pubmed.ncbi.nlm.nih.gov/26574589/. DOI: 10.1542/peds.2015-2372.
15.	Heller CD, O'Shea M, Yao Q, et al. Human milk intake and retinopathy of prematurity in extremely low birth weight infants[J]. Pediatrics, 2007, 120(1): 1-9. DOI: 10.1542/peds.2006-1465.
16.	Gregory KE,Walker WA. Immunologic factors in human milk and disease prevention in the preterm Infant[J/OL]. Curr Pediatr Rep, 2013, 1(4): 10[2013-12-01]. https://pubmed.ncbi.nlm.nih.gov/24392283/. DOI: 10.1007/s40124-013-0028-2.
17.	Hellstr?m A, Smith LE, Dammann O. Retinopathy of prematurity[J]. Lancet, 2013, 382(9902): 1445-1457. DOI: 10.1016/S0140-6736(13)60178-6.
18.	Kon IY, Shilina NM, Gmoshinskaya MV, et al. The study of breast milk IGF-1, leptin, ghrelin and adiponectin levels as possible reasons of high weight gain in breast-fed infants[J]. Ann Nutr Metab, 2014, 65(4): 317-323. DOI: 10.1159/000367998.
19.	Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors[J]. Pediatr Clin North Am, 2013, 60(1): 49-74. DOI: 10.1016/j.pcl.2012.10.002.
20.	Manzoni P, Rinaldi M, Cattani S, et al. Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial[J]. JAMA, 2009, 302(13): 1421-1428. DOI: 10.1001/jama.2009.1403.
21.	Manzoni P, Maestri A, Leonessa M, et al. Fungal and bacterial sepsis and threshold ROP in preterm very low birth weight neonates[J]. J Perinatol, 2006, 26(1): 23-30. DOI: 10.1038/sj.jp.7211420.

1. Yau GSK, Lee JWY, Tam VTY, et al. Incidence and risk factors for retinopathy of prematurity in extreme low birth weight Chinese infants[J]. Int Ophthalmol, 2015, 35(3): 365-373. DOI: 10.1007/s10792-014-9956-2.
2. 高琦, 張亞娟, 田秀英, 等. 母乳強化劑添加時間對極低出生體質量兒早期生長發育及并發癥發生率的影響[J]. 中華實用兒科臨床雜志, 2017, 32(7): 528-531. DOI: 10.3760/cma.j.issn.2095-428X.2017.07.014.Gao Q, Zhang YJ, Tian XY, et al. Effect of adding time of human milk fortifier on growth and incidence of complications of very low birth weight premature infants[J]. Chin J Appl Clin Pediatr, 2017, 32(7): 528-531. DOI: 10.3760/cma.j.issn.2095-428X.2017.07.014.
3. Alpay A, U?urba? SH. Incidence and risk factors for retinopathy of prematurity in the West Black Sea region, Turkey[J]. Turk J Pediatr, 2012, 54(2): 113-118.
4. 中華醫學會眼科學分會眼底病學組. 中國早產兒視網膜病變篩查指南(2014年)[J]. 中華眼科雜志, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association. Guidelines for screening retinopathy of premature infants in China(2014)[J]. Chin J Ophthalmol, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.
5. International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited[J]. Arch Ophthalmol, 2005, 123(7): 991-999. DOI: 10.1001/archopht.123.7.991.
6. 查汝勤, 王瓊, 劉輝. 安徽省婦幼保健院1041名早產兒或低體重兒早產兒視網膜病變篩查結果[J]. 中華眼底病雜志, 2019, 35(5): 496-497. DOI: 10.3760/cma.j.issn.1005-1015.2019.05.014.Zha RQ, Wang Q, Liu H. Screening results of retinopathy of premature infants in 1041 premature infants or low birth weight infants in Anhui Women and Child's Hospital[J]. Chin J Ocul Fundus Dis, 2019, 35(5): 496-497. DOI: 10.3760/cma.j.issn.1005-1015.2019.05.014.
7. Bas AY, Koc E, Dilmen U, et al. Incidence and severity of retinopathy of prematurity in Turkey[J]. Br J Ophthalmol, 2015, 99(10): 1311-1314. DOI: 10.1136/bjophthalmol-2014-306286.
8. Akyüz-ünsal A?, Key ?, Güler D, et al. Retinopathy of prematurity risk factors: does human milk prevent retinopathy of prematurity?[J]. Turk J Pediatr, 2019, 61(1): 13-19. DOI: 10.24953/turkjped.2019.01.003.
9. 高宏程, 陳晨, 張迎秋, 等. 早產兒視網膜病變的危險因素研究進展[J]. 國際眼科雜志, 2018, 18(1): 80-83. DOI: 10.3980/j.issn.1672-5123.2018.1.18.Gao HC, Chen C, Zhang YQ, et al. Research progress on risk factors of retinopathy of prematurity[J]. Int Eye Sci, 2018, 18(1): 80-83. DOI: 10.3980/j.issn.1672-5123.2018.1.18.
10. 祝巍, 王書蘭. 母乳喂養對早產兒視網膜病變的影響[J]. 中外女性健康研究, 2020, 3(6): 75-77.Zhe W, Wang SL. The effect of human milk feeding on retinopathy of prematurity[J]. Women's Health Research, 2020, 3(6): 75-77.
11. Bharwani SK, Green BF, Pezzullo JC, et al. Systematic review and meta-analysis of human milk intake and retinopathy of prematurity: a significant update[J]. J Perinatol, 2016, 36(11): 913-920. DOI: 10.1038/jp.2016.98.
12. Manzoni P, Stolfi I, Pedicino R, et al. Human milk feeding prevents retinopathy of prematurity (ROP) in preterm VLBW neonates[J]. Early Hum Dev, 2013, 89 Suppl 1: S64-68. DOI: 10.1016/S0378-3782(13)70019-7.
13. Hylander MA, Strobino DM, Pezzullo JC, et al. Association of human milk feedings with a reduction in retinopathy of prematurity among very low birthweight infants[J]. J Perinatol, 2001, 21(6): 356-362. DOI: 10.1038/sj.jp.7210548.
14. Zhou J, Shukla VV, John D, et al. Human milk feeding as a protective factor for retinopathy of prematurity: a meta-analysis[J/OL]. Pediatrics, 2015, 136(6): e1576-1586[2015-11-16]. https://pubmed.ncbi.nlm.nih.gov/26574589/. DOI: 10.1542/peds.2015-2372.
15. Heller CD, O'Shea M, Yao Q, et al. Human milk intake and retinopathy of prematurity in extremely low birth weight infants[J]. Pediatrics, 2007, 120(1): 1-9. DOI: 10.1542/peds.2006-1465.
16. Gregory KE,Walker WA. Immunologic factors in human milk and disease prevention in the preterm Infant[J/OL]. Curr Pediatr Rep, 2013, 1(4): 10[2013-12-01]. https://pubmed.ncbi.nlm.nih.gov/24392283/. DOI: 10.1007/s40124-013-0028-2.
17. Hellstr?m A, Smith LE, Dammann O. Retinopathy of prematurity[J]. Lancet, 2013, 382(9902): 1445-1457. DOI: 10.1016/S0140-6736(13)60178-6.
18. Kon IY, Shilina NM, Gmoshinskaya MV, et al. The study of breast milk IGF-1, leptin, ghrelin and adiponectin levels as possible reasons of high weight gain in breast-fed infants[J]. Ann Nutr Metab, 2014, 65(4): 317-323. DOI: 10.1159/000367998.
19. Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors[J]. Pediatr Clin North Am, 2013, 60(1): 49-74. DOI: 10.1016/j.pcl.2012.10.002.
20. Manzoni P, Rinaldi M, Cattani S, et al. Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial[J]. JAMA, 2009, 302(13): 1421-1428. DOI: 10.1001/jama.2009.1403.
21. Manzoni P, Maestri A, Leonessa M, et al. Fungal and bacterial sepsis and threshold ROP in preterm very low birth weight neonates[J]. J Perinatol, 2006, 26(1): 23-30. DOI: 10.1038/sj.jp.7211420.

Chinese Journal of Ocular Fundus Diseases

Study on the effect of milk feeding on the incidence of retinopathy of prematurity

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