607 - Comparative Analysis of Donor Milk and Mother's Own Milk: Similar Risks for Retinopathy of Prematurity (ROP) in Very Low Birth Weight (VLBW) Infants
Saturday, April 26, 2025
2:30pm – 4:45pm HST
Publication Number: 607.4506
Kyle J. White, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Elijah M. Harding, Medical University of South Carolina, Charleston, SC, United States; Kinsey E. Shirer, MUSC Children's Hospital, Mt Pleasant, SC, United States; myla Ebeling, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Carol L. Wagner, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Lakshmi D. Katikaneni, MUSC Children's Hospital, Charleston, SC, United States
Student Medical University of South Carolina College of Medicine Charleston, South Carolina, United States
Background: Exclusive nutrition with donor milk (DBrM) is associated with poorer growth outcomes compared to formula or mother's own milk (MoM) in VLBW ( < 1500 g) infants. However, DBrM provides significant benefits, including a reduction in necrotizing enterocolitis. The association between VLBW nutrition and the risk of ROP remains unclear. Objective: Determine the impact of donor milk nutrition on the risk of developing ROP in VLBW infants. We hypothesized that DBrM nutrition is associated with a similar risk of developing ROP as MoM-fed infants and a lower risk compared to formula-fed infants. Design/Methods: A cohort of VLBW infants screened for ROP between 2016-2020 was analyzed, considering maternal and infant clinical and sociodemographic factors. A total of 1094 mother/infant pairs were included, with infants receiving either MoM or DBrM until 34 weeks’ corrected age (CA). Data collection followed NICHD guidelines and were analyzed using SAS 9.4 software. Bivariate analysis and linear regression were performed to compare ROP risk, controlling for specific factors. Results: Among the 1094 infants, 193 were diagnosed with ROP of any stage, and 755 were not. Infants without ROP were more likely to be born to mothers with gestational hypertension (gHTN; p=0.02) and hypertensive disorders of pregnancy (HDoP; p< 0.0001), while those with ROP were more likely born to moms with maternal chorioamnionitis (p=0.02). There was a trend of higher rates of ROP among black American infants (p=0.08) Additionally, infants with ROP had smaller birth weights (BW; p< 0.0001), lower gestational age (GA; p< 0.0001), more days on ventilation (p < 0.0001), longer hospitalization (p < 0.0001), received steroids (p < 0.0001), had a patent ductus arteriosus (PDA; p< 0.0001), were discharged on oxygen (p < 0.0001), and were fed formula at discharge (p < 0.0001). In a logistic regression modeling ROP, and controlling for gHTN, chorioamnionitis, neonatal steroids, PDA, home on oxygen, d/c on breast milk, bw, GA, days on respirator, and length of hospital stay, not being discharged on breast milk (p=0.0340), lower bw (p=0.0001), smaller GA (p=0.0004), and longer hospital stay (p=0.0362) were associated with ROP.
Conclusion(s): These findings suggest that DBrM and MoM pose similar ROP risks in VLBW infants, while those fed formula after 34 weeks CA increases this risk. The potential advantages of DBrM over formula in reducing ROP incidence among VLBW infants are highlighted. Further research is warranted to explore the dose-dependent effects of MoM on ROP risk and to identify additional influencing factors.
