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Effect of human milk and other neonatal variables on lung function at three months corrected age
Francesco Beretta1, Anna Lavizzari1, Nicola Pesenti2
1Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
Insights
Early lung function assessment in preterm infants reveals that being female is linked to better tidal volume. Longer mechanical ventilation and being small for gestational age negatively impact expiratory flow, but human milk feeding shows promise for improving respiratory function in very low birth weight infants.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Preterm infants often experience respiratory complications.
- Early lung function assessment is crucial for monitoring respiratory health in this vulnerable population.
Purpose of the Study:
- To evaluate the impact of human milk feeding and neonatal variables on tidal breathing flow-volume loop (TBFVL) parameters.
- To assess respiratory function in infants born preterm (≤32 weeks or <1500g) within three months of corrected age.
Main Methods:
- Retrospective study of 121 preterm infants with TBFVL analysis.
- Investigated the influence of gestational age, gender, small for gestational age (SGA) status, sepsis, mechanical ventilation (MV) duration, and human milk feeding (HMF).
- Analysis performed on the entire cohort and stratified by birth weight (<1000g and >1000g).
Main Results:
- Overall population showed altered tidal volume (Vt) and expiratory flow parameters.
- Female infants had better weight-standardized tidal volume (Vt/Kg).
- Longer MV duration and SGA status were associated with worse time to peak expiratory flow to expiratory time (tPTEF/tE).
- For infants <1000g, HMF was positively associated with tPTEF/tE.
Conclusions:
- Early TBFVL assessment identifies lung function alterations in preterm infants.
- Female gender is associated with improved Vt/Kg, while longer MV and SGA negatively impact tPTEF/tE.
- A positive association between HMF and improved tPTEF/tE in very low birth weight infants warrants further investigation.
Objective:
To evaluate the impact of human milk and different neonatal variables on tidal breathing flow-volume loop (TBFVL) parameters within three months' corrected age (CA) in infants born ≤32 wks or weighing <1500 g.
Methods:
We retrospectively studied 121 infants with gestational age (GA) ≤ 32 weeks or birth weight (BW) <1500 gr who had lung function assessment within three months' CA by TBFVL analysis between June 2009 and April 2018. We investigated the impact of GA, gender, being Small for GA (SGA), sepsis, days of mechanical ventilation (MV) and human milk feeding (HMF) on later respiratory function, both in the entire group and according to BW ( ≤1000 g and >1000 g).
Results:
The mean(SD) z-score for tidal volume (Vt) and time to peak expiratory flow to expiratory time (tPTEF/tE) were respectively -4.3 (2.5) and -0.8 (2.0) for the overall population with no significant differences between infants <1000 g or ≥1000 g. The mean(SD) Vt standardized for body weight was 6.2(2.0) ml/kg. Being female was associated with better Vt/Kg, whereas longer MV or being born SGA were associated with worst tPTEF/tE. For infants with BW < 1000 gr, tPTEF/tE was positively associated with HMF.
Conclusion:
An early TBFVL assessment within three months' CA already reveals lung function alteration in preterm infants. Being female is associated with better Vt/Kg, while longer duration of MV or being born SGA negatively affect tPTEF/tE. The positive association between HMF and better tPTEF/tE in infants with BW <1000 g has emerged, which deserves further investigation.
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