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Quantitative Threshold Analysis: Assessing Breastfeeding's Protective Impact on Bronchopulmonary Dysplasia in Preterm
Mengqing Pan1,2, Yijia Chen1,2, Xiaoyu Lu2
1Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China, wmu.edu.cn.
Insights
Breastfeeding protects premature infants from bronchopulmonary dysplasia (BPD). The protective effect becomes significant only when the breastfeeding rate reaches 31%, indicating a crucial threshold for BPD prevention.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Public Health Nutrition
Background:
- Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
- Breastfeeding is recognized for its health benefits in neonates.
- The specific impact of breastfeeding rates on BPD incidence requires further elucidation.
Purpose of the Study:
- To investigate the protective effects of varying breastfeeding rates on BPD in preterm infants.
- To clarify the relationship between breastfeeding proportion and BPD.
- To determine the minimum protective breastfeeding threshold for BPD.
Main Methods:
- Prospective study of 276 preterm infants admitted to NICU.
- Infants categorized into low, medium, and high breastfeeding proportion groups.
- Statistical analysis including nonlinear regression to identify protective thresholds.
Main Results:
- BPD incidence was significantly lower in the high breastfeeding group (19.5%) compared to medium (44.5%) and low (55%) groups (p < 0.05).
- No significant difference in BPD incidence between medium and low breastfeeding groups (p > 0.05).
- An inflection point around 31% breastfeeding proportion suggested a stronger protective effect above this threshold.
Conclusions:
- Breastfeeding is crucial for protecting preterm infants against BPD.
- A breastfeeding rate of at least 31% appears necessary for a significant protective effect against BPD.
- This threshold finding requires validation in larger, more comprehensive studies.
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.
