Background Human breast milk-fed preterm infants can accumulate nutrient deficits leading to extrauterine growth restriction. Feeding preterm infants with multi-nutrient fortified human milk could increase nutrient accretion and growth rates and improve neurodevelopmental outcomes. Concern exists, however, that multi-nutrient fortifiers are associated with adverse events such as feed intolerance and necrotising enterocolitis. Objectives To determine whether multi-nutrient fortified human milk, compared with unfortified human milk, a ects important outcomes (including growth rate and neurodevelopment) of preterm infants without increasing the risk of adverse e ects (such as feed intolerance and necrotising enterocolitis).

Exposure to the smell and taste of milk to accelerate feeding in preterm infants (Review)

ObjectiveEndometriosis is considered as a serious gynaecological disease in women at a reproductive age. Lower body mass index (BMI) is thought to be a risk factor. However, recent studies indicated that women with normal BMI were also more likely to develop endometriosis, suggesting the association with BMI is controversial. We therefore investigated the association of BMI and surgically diagnosed endometriosis in a cohort of Chinese women.DesignRetrospective case–control study.SettingTertiary hospital.Patients709 women with endometriosis and 807 age matched controls between January 2018 and August 2019.InterventionAge at diagnosis, parity, gravida, BMI and self-reported dysmenorrhoea status were collected and the association of BMI and endometriosis was analysed.Measurement and main resultsOverall, the median BMI was not different between patients and controls (21.1 kg/m2 vs 20.9 kg/m2, p=0.223). According to the BMI categories for Asians/Chinese by WHO (underweight: <18.5 kg/m2, normal weight: 18.5–22.99 kg/m2, overweight: 23–27.49 kg/m2, obese: ≥27.50 kg/m2), overall, there was no difference in the association of BMI and endometriosis (p=0.112). 60% of patients were of normal weight. However, the OR of obese patients (BMI over 27.50 kg/m2) having endometriosis was1.979 (95% CI 1.15 to 3.52, p=0.0185), compared with women with normal weight. 50.3% patients reported dysmenorrhoea, and the OR of developing severe dysmenorrhoea in obese patients (BMI over 27.50 kg/m2) was 3.64 (95% CI 1.195 to 10.15, p=0.025), compared with patients with normal weight.ConclusionOur data demonstrate that overall there was no association between BMI and the incidence of endometriosis, but there was a significant increase in the incidence of endometriosis in obese women, compared with women with normal weight. Obesity was also a risk factor for severe dysmenorrhoea.

Key PointsQuestionAmong late preterm and term infants born at risk of neonatal hypoglycemia, does prophylactic oral 40% dextrose gel 1 hour after birth alter the risk of neurosensory impairment at 2 years’ corrected age?FindingsIn this prospective follow-up of a subset of 1321 participants enrolled in a randomized clinical trial, the prevalence of neurosensory impairment was 21% among those randomized to prophylactic oral dextrose gel and 19% among those randomized to placebo gel, a difference that was not statistically significant.MeaningAdministration of prophylactic oral dextrose gel to at-risk late preterm and term infants, compared with placebo, resulted in no significant difference in the risk of neurosensory impairment at 2 years’ corrected age, although the study may have been underpowered to detect a small but potentially clinically important difference in risk.

ImportanceNeonatal hypoglycemia is common, but its association with later neurodevelopment is uncertain.ObjectiveTo examine associations between neonatal hypoglycemia and neurocognitive outcomes at corrected age 2 years.Design, Setting, and ParticipantsExploratory cohort analysis of the Hypoglycaemia Prevention With Oral Dextrose (hPOD) randomized clinical trial was conducted. The trial recruited participants from January 9, 2015, to May 5, 2019, with follow-up between January 26, 2017, and July 31, 2021. Infants were recruited from 9 maternity hospitals in New Zealand and assessed at home or in a research clinic. Children born late preterm and at term at risk of neonatal hypoglycemia but without evidence of acute or imminent illness in the first hour after birth were screened and treated to maintain blood glucose concentrations greater than or equal to 47 mg/dL.ExposuresHypoglycemia was defined as any blood glucose concentration less than 47 mg/dL, recurrent as 3 or more episodes, and severe as less than 36 mg/dL.Main Outcomes and MeasuresNeurologic examination and tests of development (Bayley III) and executive function. The primary outcome was neurosensory impairment (any of the following: blindness, deafness, cerebral palsy, developmental delay, or executive function total score worse than 1.5 SD below the mean).ResultsA total of 1197 of 1321 (91%) eligible children were assessed at a mean of corrected age 24 months; 616 (52%) were male. Compared with the normoglycemia group, children who experienced hypoglycemia were more likely to have neurosensory impairment (111 [23%] vs 125 [18%]; adjusted risk ratio [aRR], 1.28; 95% CI, 1.01-1.60), particularly if they experienced severe episodes (30 [28%] vs 125 [18%]; aRR, 1.68; 95% CI, 1.20-2.36), but not recurrent episodes (12 [19%] vs 125 [18%]; aRR, 1.06; 95% CI, 0.63-1.80). The risk of cognitive, language, or motor delay was similar between groups, but children who experienced hypoglycemia had lower Bayley-III composite cognitive (adjusted mean difference [aMD], −1.48; 95% CI, −2.79 to −0.18) and motor scores (aMD, −2.05; 95% CI, −3.30 to −0.79).Conclusions and RelevanceIn children born at risk of hypoglycemia but otherwise well, those who experienced neonatal hypoglycemia were more likely to have neurosensory impairment at corrected age 2 years, with higher risks after severe episodes. Further research is required to determine causality.