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• W3204669364 abstract "<h3>Background</h3> Breast milk fortifier (BMF) helps maintain adequate nutrition in preterm infants, which is crucial for their physical and neurodevelopmental outcomes. However, conflicting reports have linked BMF with the development of necrotising enterocolitis (NEC), a devastating condition with high morbidity and mortality among neonates. <h3>Objectives</h3> We undertook a ten-year retrospective analysis in our tertiary Neonatal Unit (NNU) in London, United Kingdom (UK) to evaluate the association of BMF use in preterm infants with various neonatal outcomes. We primarily examined if BMF use is associated with the development of NEC, as well as with the development of the more high-mortality group of patients who develop surgical NEC. We also examined if there is an association between BMF use and all-cause mortality. <h3>Methods</h3> The audit cohort included babies inborn at St George’s Hospital, London, UK, between gestational ages 23⁺⁰ and 31⁺⁶ weeks, admitted to the NNU from January 2010 – September 2020, who had been discharged or were deceased (N=952). Data was collected from the electronic neonatal database system (Badgernet UK). BMF use and NEC were confirmed from clinical notes and NEC was stratified by severity; those with NEC, Bell’s stage II and above were included. Statistical analysis: odds ratios and risk ratios were calculated with corresponding confidence intervals and number needed to treat (where applicable). Subgroups for analysis included all gestational ages, and those with gestational ages between 23⁺⁰ – 25⁺⁶ weeks, 26⁺⁰ – 28⁺⁶ weeks, and 29⁺⁰ – 31⁺⁶ weeks. <h3>Results</h3> This audit established that BMF has been increasingly used in preterm infants from 2010 – 2020 (10.5% of preterm infants on the NNU in 2010 received BMF, compared to 45.8% in 2020). Contrastingly, NEC rates on the NNU have remained stable across the 10 year audit timeframe (6.3% from 2010 – 2014; 5.8% from 2015 to 2019). Use of BMF did <i>not</i> increase the odds or risk of developing NEC (OR 0.62, CI 0.30 to 1.29; RR 0.64, CI 0.32 to 1.28). BMF use in preterm infants was associated with a reduced risk of developing surgical/severe NEC (RR 0.24, CI 0.06 to 0.99, P 0.05, NNT (benefit) 18.04 – 344). Furthermore, BMF <i>did not</i> lead to an increased risk of all-cause mortality in preterm infants across the ten year audit (RR 0.31, CI 0.15 to 0.63, P 0.001, NNT (Benefit) 7.95–27.42). Extremely premature infants, born <26 weeks gestation, had less risk of developing NEC if on BMF (RR 0.36, CI 0.16 to 0.90, P 0.01, NNT (Benefit) 4.97–30.3). <h3>Conclusions</h3> BMF use in preterm infants on our NNU from 2010–2020 was not associated with an increased risk of NEC development, nor an increase in all-cause mortality. This was true for all subgroups analysed. Further work is being undertaken to examine the possible protective effect of BMF in some patients." @default.
• W3204669364 created "2021-10-11" @default.
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• W3204669364 date "2021-09-30" @default.
• W3204669364 modified "2023-09-25" @default.
• W3204669364 title "1379 Exploring the role of breast milk fortifier in neonatal outcomes in preterm neonates, a 10 year retrospective audit" @default.
• W3204669364 doi "https://doi.org/10.1136/archdischild-2021-rcpch.602" @default.
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