Affiliations: Department of Pediatrics/Division of Neonatology,
University of Texas Health Science Center, San Antonio, TX, USA
Note: [] Corresponding author: Cynthia L. Blanco, M.D., Department of
Pediatrics/Division of Neonatology, University of Texas Health Science Center,
7703 Floyd Curl Drive, MSC 7812, San Antonio, TX 78229-3900, USA. Tel.: +1 210
567 5225; Fax: +1 210 567 5169; E-mail: blanco@uthscsa.edu
Abstract: Objective: Necrotizing enterocolitis (NEC) causes significant
morbidity and mortality in very low birth weight (VLBW) infants. Our objective
was to assess the influence of pasteurized donor human milk (PDHM) on the
incidence of NEC. Methods: This is a retrospective chart review of 179
VLBW (< 1500 g) infants born in the pre-PDHM era (January 2001–March
2003) vs 152 born in the post-PDHM era (April 2003–December 2004). Results: The cohorts had similar demographic characteristics. The overall
incidence of NEC was 12% in the pre-PDHM era vs 10% in the post-PDHM.
Although not statistically significant, surgical NEC decreased from 7% to
3% respectively. Sepsis decreased from 10% to 6% between the pre and
post-PDHM eras (p=0.04). Erythropoietin administration for anemia of
prematurity was associated with a protective effect for NEC, even after
adjusting for gestational age, indomethacin and mother's own milk intake (OR
0.37, 95% CI 0.16–0.85, p=0.02). The introduction of PDHM did not
decrease the amount of mother's own milk use. Conclusions: The overall
incidence of NEC remained unchanged after the introduction of PDHM in a single
neonatal intensive care unit, but the cases of surgical NEC had a trend to
decrease. Randomized controlled clinical studies evaluating the effect of PDHM
on the severity of NEC are warranted.
