الفهرس 
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Abstract
Backgr ound: N e c r o t i z i n g e n t e r o c o l i t i s ( N E C ) i s m a j o r gastrointestinal problem in premature infants crying a high morbidity and mortality risk. Transforming growth factor beta2(TGF-β2) is among the protective factors against NEC
Objectives: assess occurance of feeding intolerance and NEC in relation to serum level of TGF-β2 in breast milk versus preterm formula fed neonates.
Subjects and methods: 80 preterm neonates(≤36weeks gestational age) were involved in a prospective observational study. They are divided to two groups; breast milk fed group(n=40,received breast milk exclusively) and preterm formula fed group(n=40, received premature formula when maternal milk was not available). They were assessed clinically for feeding intolerance and NEC and laboratory by measurement of TGF-β2 using ELISA technique.
Results:TGF-β2 serum level was significantly lower in preterm formula fed group than breast fed group;median(interquartile)
500(250-3000) pg/ml vs 7750(6500-11250) pg/ml (p <0.0001). Both primary outcome(feeding intolerance and NEC) and secondary outcome(respiratory support and sepsis) were negatively correlated to TGF-β2 serum level. TGF-β2 serum level below 1250 pg/ml is a good diagnostic test for feeding intolerance with sensitivity of 75.86 and specificity of 96.08.
Conclusion:lower serumTGF-β2 level has a role in feeding intolerance in preterm neonate is not recommended as it’s associated with lower serum TGF-β2 and higher incidence of feeding intolerance compared to breast feeding.