dc7212e46102677b72108e140638e977 317394.pdf e4086a2d5441a3e30d44ae113ce0a47a32644ddf 317394.pdf 1a3c4dc9d6918395d620193f9ada6390ecdf46dbb9679b87126c912a4e0b3735 317394.pdf Title: Human Milk Feeding Is Associated with Decreased Incidence of Moderate-Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants Subject: Background: An increased rate of bronchopulmonary dysplasia (BPD) is reported in extremely preterm infants. A potential role of human milk feeding in protecting against this condition has been suggested. Methods: A retrospective descriptive study was conducted based on data about morbidity in the population of infants born between 22+0 and 26+6 weeks of gestation, included in the Spanish network SEN1500 during the period 2004–2019 and discharged alive. The primary outcome was moderate-severe BPD. Associated conditions were studied, including human milk feeding at discharge. The temporal trends of BPD and human milk feeding rates at discharge were also studied. Results: In the study population of 4341 infants, the rate of moderate-severe BPD was 43.7% and it increased to >50% in the last three years. The factors significantly associated with a higher risk of moderate-severe BPD were birth weight, male sex, high-frequency oscillatory ventilation, duration of invasive mechanical ventilation, inhaled nitric oxide, patent ductus arteriosus, and late-onset sepsis. Exclusive human milk feeding and any amount of human milk at discharge were associated with a lower incidence of moderate-severe BPD (OR 0.752, 95% CI 0.629–0.901 and OR 0.714, 95% CI 0.602–0.847, respectively). During the study period, the proportion of infants with moderate-severe BPD fed any amount of human milk at discharge increased more than twofold. And the proportion of infants with moderate-severe BPD who were exclusively fed human milk at discharge increased at the same rate. Conclusions: Our work shows an inverse relationship between human milk feeding at discharge from the neonatal unit and the occurrence of BPD. Keywords: bronchopulmonary dysplasia; human milk feeding; breastfeeding; extremely preterm Author: Sergio Verd, Roser Porta, Gemma Ginovart, Alejandro Avila-Alvarez, Fermín García-Muñoz Rodrigo, Montserrat Izquierdo Renau and Paula Sol Ventura Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sun Jul 23 08:16:51 2023 CEST ModDate: Sun Jul 23 08:21:48 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1427069 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- HCRKXL+VnURWPalladioL Type 1 Custom yes yes no 10 0 DLWYOK+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 KDMQTZ+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 YGWAME+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 WLENKM+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 YJPPHJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 GLXBXS+CMSY10 Type 1 Builtin yes yes no 71 0 FFEJCI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 154 0 FFEJCJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 160 0 FFEJEJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 166 0 FFEJEK+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 172 0 FFEJEL+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 175 0 FFEJEM+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 178 0 FFEJLK+PalatinoLinotype-Roman TrueType MacRoman yes yes no 181 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 237 0 FFEJCI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 250 0 FFFDHC+PalatinoLinotype-Italic TrueType MacRoman yes yes no 256 0 FFEJCJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 259 0 FFEJEJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 265 0 FFEJEK+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 271 0 FFEJEL+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 274 0 FFEJEM+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 277 0 FFEJLK+PalatinoLinotype-Roman TrueType MacRoman yes yes no 280 0 FFEJCI+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 291 0 FFFELL+Calibri CID TrueType Identity-H yes yes yes 297 0 FFEJCJ+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 303 0 FFEJEJ+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 309 0 FFEJEK+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 315 0 FFEJEL+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 318 0 FFEJEM+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 321 0 FFEJLK+PalatinoLinotype-Roman TrueType MacRoman yes yes no 324 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-07-25 02:51:34 CEST RepresentationInformation: 317394.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-07-24 14:48:48 CEST Size: 1427069 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 518 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design Destination: subsection.2.1 Item: Title: Population Destination: subsection.2.2 Item: Title: Variables Destination: subsection.2.3 Item: Title: Ethics Requirements Destination: subsection.2.4 Item: Title: Statistical Analysis Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Selection of Study Cohort Destination: subsection.3.1 Item: Title: Infants’ Characteristics Destination: subsection.3.2 Item: Title: Discussion Destination: section.4 Children: Item: Title: The Changing Epidemiology of BPD over the Study Period Destination: subsection.4.1 Item: Title: Other Likely Mechanisms Underlying the Effects of HM Feeding on BPD Destination: subsection.4.2 Item: Title: Lower Risk of BPD among HM-Fed Preterm Infants Destination: subsection.4.3 Children: Item: Title: Limitations Destination: subsubsection.4.3.1 Item: Title: Strengths Destination: subsubsection.4.3.2 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.A. Info: Title: Human Milk Feeding Is Associated with Decreased Incidence of Moderate-Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants Author: Sergio Verd, Roser Porta, Gemma Ginovart, Alejandro Avila-Alvarez, Fermín García-Muñoz Rodrigo, Montserrat Izquierdo Renau and Paula Sol Ventura Subject: Background: An increased rate of bronchopulmonary dysplasia (BPD) is reported in extremely preterm infants. A potential role of human milk feeding in protecting against this condition has been suggested. Methods: A retrospective descriptive study was conducted based on data about morbidity in the population of infants born between 22+0 and 26+6 weeks of gestation, included in the Spanish network SEN1500 during the period 2004 2019 and discharged alive. The primary outcome was moderate-severe BPD. Associated conditions were studied, including human milk feeding at discharge. The temporal trends of BPD and human milk feeding rates at discharge were also studied. Results: In the study population of 4341 infants, the rate of moderate-severe BPD was 43.7% and it increased to >50% in the last three years. The factors significantly associated with a higher risk of moderate-severe BPD were birth weight, male sex, high-frequency oscillatory ventilation, duration of invasive mechanical ventilation, inhaled nitric oxide, patent ductus arteriosus, and late-onset sepsis. Exclusive human milk feeding and any amount of human milk at discharge were associated with a lower incidence of moderate-severe BPD (OR 0.752, 95% CI 0.629 0.901 and OR 0.714, 95% CI 0.602 0.847, respectively). During the study period, the proportion of infants with moderate-severe BPD fed any amount of human milk at discharge increased more than twofold. And the proportion of infants with moderate-severe BPD who were exclusively fed human milk at discharge increased at the same rate. Conclusions: Our work shows an inverse relationship between human milk feeding at discharge from the neonatal unit and the occurrence of BPD. Keywords: bronchopulmonary dysplasia; human milk feeding; breastfeeding; extremely preterm Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sun Jul 23 08:16:51 CEST 2023 ModDate: Sun Jul 23 08:21:48 CEST 2023 ID: 0xf82931672e48236960a781fb64265e4b, 0xf82931672e48236960a781fb64265e4b Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: KDMQTZ+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: KDMQTZ+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: GLXBXS+CMSY10 FontSubset: true FirstChar: 0 LastChar: 48 FontDescriptor: FontName: GLXBXS+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: YGWAME+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 121 FontDescriptor: FontName: YGWAME+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: 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