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Preterm Human Milk pH: A Systematic Review and Meta Analysis

2024; Elsevier BV; Volume: 8; Linguagem: Inglês

10.1016/j.cdnut.2024.103102

2475-2991

Mindy Patterson, Ariana Bailey, Tonya Bender, Dixie Carter, Jennifer N Kinnaman, Derek Miketinas,

Digestive system and related health

Objectives: The pH of human milk (HM) can influence nutrient and bioactive assimilation, infection rate, gut microbiome composition, and thus overall growth and development in preterm infants. The objective of this study was to conduct a systematic review and meta-analysis of studies measuring the pH of HM from mothers who delivered preterm (≤ 37 wk gestational age (GA)). Methods: Ebsco, PubMed, and Scopus databases were searched by a research librarian through July 2023 to identify intervention and observational studies measuring the pH of preterm HM. Using Covidence software, two independent reviewers systematically reviewed titles, abstracts, and full text articles for inclusion criteria. Inclusion criteria were: studies published until July 2023, published in English, and that reported HM composition from mothers who delivered preterm. Exclusion criteria included studies whose samples were from countries with a Human Developing Index < 0.8 and studies with an n=1. HM samples were treated as the sampling unit. For studies that reported pH across subgroups, the total sample mean and standard deviation were estimated. A random effects model was used to estimate pH content given the high heterogeneity among studies. This meta-analysis is registered with PROSPERO (CRD42023445191). Results: Of the 884 studies identified, 68 were removed as duplicates. 487 were considered irrelevant based on abstract review. 322 studies were reviewed for full text and six studies reported preterm (ranges: GA 24 - 25.76 wk; 1000 - 2215 g birth weight) HM pH content representing 87 mothers and 124 samples. The mean pH value ranged from 6.38 to 7.26. The meta-analysis indicated a mean(SE) of 6.89(0.089) (95% CI: 6.67,7.12) and high heterogeneity among studies (I2=88.2%). Conclusions: The mean pH of preterm HM is 6.89, which is close to neutral; however, the variation ranged from 6.38 to 7.26. Understanding the role of preterm HM pH is important to maximize growth and development in this vulnerable infant population. Funding Sources: This project was funded by Reckitt|Mead Johnson Nutrition.