Abstract: Objective To analyze the effect of breastfeeding and artificial feeding on the prognosis of premature infants with white matter injury(WMI), in order to provide evidence for improving the prognosis of brain injury in preterm infants. Methods A retrospective study was conducted on cases of premature infants with WMI during the hospitalization in the neonatal ward of Peking University Third hospital from January 2014 to December 2018 and followed up at the Children's Health Development Center after discharge till corrected gestational age at 12 months. Then children were divided into breastfeeding group (n=69) and artificial feeding group (n=62). The gender, gestational age, birth weight, daily weight gain during hospitalization, hospitalization time, parenteral nutrition time, mechanical ventilation time, nosocomial infection rate and disease incidence rate during hospitalization were compared between breastfeeding group and artificial feeding group. Besides, the weight,total motor development quotient of Peabody Developmental Motor Scales(PMDS) and neuropsychological development score at the corrected gestational age of 2, 6 and 12 months old were compared between the two groups. Results Compared with those in the artificial feeding group, the nosocomial infection rate(25% vs. 58%) and the incidence of periventricular leukomalacia (11% vs. 39%) in breastfeeding group were significantly higher(χ²=4.431, 5.380, P<0.05). The total motor development quotient of the PMDS at the corrected age of 2 months old was significantly higher in the breastfeeding group (95.5±8.8 vs. 91.1±6.7, t=3.238, P＜0.05). Conclusion Breastfeeding plays a crucial role in improving the prognosis of WMI of preterm infants.

Key words: breastfeeding, artificial feeding, premature infants, white matter injure

摘要： 目的 分析母乳喂养与人工喂养对早产儿脑白质损伤预后的影响,为改善早产儿脑损伤的预后提供依据。方法 回顾性研究2014年1月—2018年12月在北京大学第三医院新生儿病房住院期间诊断脑白质损伤,出院后在本院儿童健康发展中心随诊至矫正胎龄12月的131例早产儿的资料,分为母乳喂养组(n=69)和人工喂养组(n=62)。比较两组患儿性别、胎龄、出生体重、住院期间日增体重、住院时间、肠外营养时间、呼吸机使用时间、院内感染率、以及在住院期间所患疾病发生率;比较两组患儿矫正2、6、12月龄体重,Peabody运动发育量表总运动发育商和小儿神经运动心理发育评分。结果 母乳喂养组院内感染率(25%)和早产儿脑室白质周围白质软化发病率(11%)比人工喂养组低(58%、39%),差异有统计学意义与(χ²=4.431、5.380,P＜0.05);矫正2月龄Peabody运动发育量表总运动发育商(95.5±8.8)较人工喂养组(91.1±6.7)高,差异有统计学意义(t=3.238,P＜0.05)。结论 母乳喂养对早产儿脑室白质损伤预后改善有一定意义。

关键词: 母乳喂养, 人工喂养, 早产儿, 脑白质损伤