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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2012, Number 6

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Rev Invest Clin 2012; 64 (6)

Breastfeeding and metabolic indicators in Mexican premature newborns

Monroy-Torres R, Naves-Sánchez J, Ortega-García JA

Language: English
References: 29
Page: 521-528
PDF size: 176.35 Kb.


ABSTRACT

Background. Morbidity and mortality rates are higher among preterm infants due to physiological immaturity and greater growth demands. Nutritional intervention contributes to proper weight gain, which translates into better growth and neurological development, and prevents the onset of metabolic complications. The effect of breastfeeding duration was studied in the analytic profile at the end of the first six months of life. Objective. To describe the nutritional and metabolic markers effect in preterm infants at the end of the first semester of life. Material and methods.We performed an analytical, transversal and comparative study in 100 preterm infants, 30 to 36 weeks gestational age. Measures for weight, length and head circumference at birth were taken from the subjects’ clinical files. A follow-up conducted at 6 to 9 months of age evaluated the same nutritional indicators (weight, length, head circumference) and compared them with values at birth and recommendations. Metabolic indicators (glucose, hemoglobin, cholesterol, triglycerides, insulin, urea, creatinine, gamma-glutamyl-transferase and alkaline phosphatase) were compared with the recommendations. Follow-up study in 100 preterm infants (30 to 36 weeks gestational age). Weight, length and head circumference were measured at birth and 6 to 9 months later. We measured analytic parameters related to metabolic syndrome (glucose, hemoglobin, cholesterol, triglycerides, insulin, urea, creatinine, gamma-glutamyl transferase and alkaline phosphatase). Confusing factors like income level and access to public services were also studied. Results. The mean age at follow-up was 7.3 ± 1.4 months. Levels of hemoglobin, creatinine and urea showed significant differences with regard to reference values (Wilcoxon ranks test, ‹ 0.05). The average duration of breastfeeding was 4.3 months. The mean age at follow-up was 7.3 ± 1.4 months. Risk factors for hypercholesterolemia, as well as levels of hemoglobin, creatinine and urea showed significant differences with regard to reference values (Wilcoxon ranks test, ‹ 0.05). Conclusions. Premature infants showed deficiencies in weight gain. Biochemical parameters could reflect metabolic risk, therefore we recommend prolonging breastfeeding as well as extending the follow-up of these infants for monitoring their growth and development once out of the hospital.


REFERENCES

  1. Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Harris J, et al. Incidencia mundial de parto prematuro: revisión sistemática de la morbilidad y mortalidad maternas. Bol OMS 2010; 88: 1-80.

  2. Villanueva LA, Contreras AK, Pichardo M, Rosales LJ. Perfil Epidemiológico del Parto Prematuro. Ginecol Obstet Mex 2008; 76(9): 542-8.

  3. Hofman PL, Regan F, Jackson WE. Premature birth and later insulin resistance. N Engl J Med 2004; 351: 2179-86.

  4. Pérez JL, Martínez PD, López J, Ibarra I, Pujol M. Nutrición artificial en las unidades de cuidados intensivos pediátricos. An Pediatr (Barc) 2005; 62(2): 105-12.

  5. Monroy-Torres R, Macías AE, Ponce-De León S, Barbosa-Sabanero G. Weight Gain and Metabolic Complications in Preterm Infants with Nutritional Support. Rev Invest Clin 2011; 63(3): 241-9.

  6. Koletzko B, Goulet O, Hunt J, Krohn K, Shamir R. Parenteral Nutrition Guidelines Working Group ESPGHAN, ESPEN. J Pediatr Gastroenterol Nutr 2005; 41(2): 1-87.

  7. Puntis JWL. Nutritional support in the premature newborn. Postgraduate Med J 2006; 82(965): 192-8.

  8. American Academy of Pediatrics, Committee on Nutrition. Commentary on parenteral nutrition. Pediatrics 1983; 71: 547-52.

  9. Barker DJ, Hales CN, Fall CH, Osmond C, Phipps K, Clark PM. Type 2 (non-insulin dependent) diabetes mellitus, hypertension and hyperlipidemia (X syndrome): relation to reduced fetal growth. Diabetol 1993; 36: 62-7.

  10. Mortaz M, Fwtrell MS. Birth weight, subsequent growth, and cholesterol metabolism in children 8-12 years old born preterm. Arch Dis Child 2001; 84: 212-7.

  11. Soto N, Bazaes RA, Peña V. Insulin sensitivity and secretion are related to match-up growth in small for gestational age infants at age 1 year: results from a prospective cohort. J Clin Endo & Metab 2003; 8: 3645-50.

  12. Fewtrell MS, Morgan JB, Duggan C, Gunnlaugsson G, Hibberd PL, Lucas A, Kleinman RE. Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations? Am J Clin Nutr 2007; 85 (Suppl.): 635-8.

  13. Lucas A, Morley R, Cole TJ, Lister G, Leeson-Payne C. Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992; 339: 261-4.

  14. Lucas A, Fewtrell MS, Morley R, Lucas PJ, Baker BA, Lister G, Bishop NJ. Randomized outcome trial of human milk fortification and developmental outcome in preterm infants. Am J Clin Nutr 1996; 64(2): 142-51.

  15. Merewood A, Philipp BL, Chawla N, Cimo S. The Baby-Friendly Hospital Initiative increases breastfeeding initiation rates in a US NICU. J Hum Lact 2003; 19: 166-71.

  16. Secretaría de Salud Federal. Estadísticas de prematurez. Disponible en: www.guanajuato.gob.mx/ssg

  17. Kleinman RE. Alimentación del niño. En: Manual de Nutrición Pediátrica. American Academy of Pediatrics. 5a. Ed. México, D.F.; 2006, p. 119.

  18. Fenton TR. A new growth chart preterm babies: Babson and Benda’s chart update with recent data and a new format. BMC Pediatrics 2003; 3: 13.

  19. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. Technical Report Series No. 854. Disponible en: http://www.who int/childgrowth/publications/ physical_status/en/index.html [Acceso: enero 2010].

  20. Meléndez L, Velázquez J. Nutridatos. Manual de Nutrición Clínica. 1a. Ed. Medellín, Colombia: Health Book’s; 2010, p 326.

  21. Nevin-Folino N. Nutrition assessment of premature infants. In: Pediatric Manual of Clinical Dietetics. 2nd. Ed. USA: American Diet Association; 2003: 127-43.

  22. Perlman M, Kirpalani H. Appendix 7: Normal values. In: Resident’s handbook of neonatology. Toronto, Canada: Mosby; 1992: 274-83.

  23. Adamkin DH. Nutritional management of the very low birthweight newborns. Neo Reviews 2006; 7(12): 602-07.

  24. Loomis T, Merrit S, Khalak R. Survey of Primary Care Physicians. Pediatrics 2010; 4(125): e891-e898.

  25. Pardo IM, Geloneze B. Atherogenic lipid profile of Brazilian near-term newborns. Braz J Med Biol Res 2005; 5: 755-60.

  26. Gray IP, Cooper PA, Cory BJ. The intrauterine environment is a strong determinant of glucose tolerance during the neonatal period, even in prematurity. J Clin Endo & Metab 2002; 9: 4252-6.

  27. Bray G, Nielsen S, Popkin B. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr 2004; 79: 537-43.

  28. Hofman PL, Regan F, Jackson WE, Jefferies C, Knight DB, Robinson EM, Cutfield WS. Premature Birth and later insulin resistance. N Engl J Med 2004; 351(21): 2179-86.

  29. Ramos A, Martínez A, Morales A, Valdez R. La prematurez y sus repercusiones en el crecimiento y desarrollo del niño, en la zona Metropolitana de Guadalajara, Jalisco, México. Salud Pública, Río de Janeiro 1998; 14: 313-18.




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