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Quantitative Threshold Analysis: Assessing Breastfeeding's Protective Impact on Bronchopulmonary Dysplasia in Preterm
Mengqing Pan1,2, Yijia Chen1,2, Xiaoyu Lu1
1School of Nursing, Wenzhou Medical University, Wenzhou, China, wmu.edu.cn.
Objective:
This study aims to thoroughly investigate the protective effects of various breastfeeding rates on bronchopulmonary dysplasia (BPD), clarify the relationship between them, and further determine the minimum protective threshold.
Methods:
This prospective study enrolled 276 preterm infants who were born in the obstetrics department of a tertiary Grade A hospital in Zhejiang, China, and were directly admitted to the NICU.
Results:
This study involved 276 infants, categorized into three breastfeeding groups based on proportion: low (100 infants, 36.2%), medium (98 infants, 35.5%), and high (78 infants, 28.3%). Notably, the incidence of BPD in the high-proportion breastfeeding group (19.5%) was significantly lower than that in the medium-proportion group (44.5%) and the low-proportion group (55%) (p < 0.05); however, there was no statistically significant difference in the incidence of BPD between the medium-proportion group and the low-proportion group (p > 0.05). Exploratory nonlinear analyses suggested a possible candidate inflection point around 0.31, above which the inverse association between breastfeeding proportion and BPD appeared stronger.
Conclusion:
Breastfeeding plays a crucial role in protecting premature infants from BPD. However, this protective effect does not increase linearly but becomes significant only when the breastfeeding rate reaches 31%. However, this threshold-related finding should be interpreted cautiously and requires validation in larger studies with more comprehensive confounder adjustment.
