INTRODUCTION: Premature infants are at risk of developing a diverse array of diseases and health problems. Breast milk seems to be protective against neonatal diseases such as necrotizing enterocolitis (NEC), a disease characterized by damage to the infant's intestinal tract. In the US, NEC is more common in African American infants compared to every other ethnicity. One protective factor seems to be oligosaccharides, specifically disialyllacto-N-tetraose (DSLNT). Therefore, this study examined the effect of ethnicity on DSLNT levels. METHODS: Breast milk was collected from 130 breastfeeding mothers that delivered term infants from day of delivery out to 338 days postpartum. Mothers self-reported their race. Breast milk was processed and analyzed by LC/MS (ESI-Q-TOF) to determine DSLNT concentrations. Primary unadjusted analysis was a two-sample t-test. Adjusted analysis by ANOVA (adjusting for days of lactation) with self-reported ethnicity dichotomized to African American or Other. IRB approval was obtained for this study. RESULTS: Self-reported race identified 66 African Americans and 64 individuals of other races in our study population. When adjusting for day of lactation, race did not have a significant effect (p-value=0.5770) on DSLNT content in term milk. CONCLUSION: DSLNT may be an important human milk oligosaccharide in preventing devastating neonatal disease. Although past studies have postulated that geographical differences in the oligosaccharide may exist, our study did not identify racial differences in the oligosaccharide in the breast milk of term neonates at our center.

outcome was the incremental cost per quality-adjusted life year (QALY). Neonatal morbidity, procedure-related loss, termination, and neonatal death were also investigated for each diagnostic strategy. The cost-effectiveness threshold was set to $100,000 per QALY. RESULTS: Microarray alone would diagnose 96.9% of significant chromosomal abnormalities.(Table 1) In our cohort, microarray alone would not detect 110 triploidy or 2,600 balanced translocations in fetuses. Karyotype alone would miss microdeletions and duplications, including 1961 pathologic CNVs and 2244 likely pathologic variants of unknown clinical significance. While adding a karyotype to microarray would prevent 137 triploidy births, it was not cost effective to conduct the karyotype / microarray combination at $227,000 per QALY. Interestingly, the approaches of karyotype and then microarray and microarray and then karyotype resulted in the same abnormalities being diagnosed and prevented. However, doing the microarray first was more expensive costing an additional $35.6 million. Furthermore, using microarray alone in women of advanced maternal age yields similar results.(Table 2) CONCLUSION: Microarray alone is a cost-effective diagnostic test in pregnancies with anomalies on ultrasonography. However, women would need to be counseled on the possibility of missing the rare triploidy.