Table 3. Associations of Maternal Milk Intake With Neurodevelopmental Outcomes at School Agea.
| Model | β (95% CI) | ||
|---|---|---|---|
| IQ (WASI b ) | |||
| Outcome | Full scale (n = 580) | Verbal (n = 577) | Performance (n = 581) |
| Per 25 mL/kg daily in the NICU | |||
| Crude | 1.01 (0.42 to 1.60) | 0.69 (0.05 to 1.33) | 1.04 (0.47 to 1.60) |
| Adjusted | 0.40 (−0.16 to 0.96) | −0.03 (−0.64 to 0.58) | 0.67 (0.10 to 1.23) |
| Per month | |||
| Crude | 0.42 (0.17 to 0.66) | 0.35 (0.10 to 0.60) | 0.39 (0.14 to 0.63) |
| Adjusted | 0.22 (−0.03 to 0.471 | 0.18 (−0.07 to 0.43) | 0.22 (−0.03 to 0.46) |
| Academic achievement (WRAT-4 b ) | |||
| Outcome | Reading standard (n = 573) | Spelling (n = 568) | Math computation (n = 574) |
| Per 25 mL/kg daily in the NICU | |||
| Crude | 1.64 (0.90 to 2.37) | 1.01 (0.33 to 1.70) | 1.26 (0.62 to 1.90) |
| Adjusted | 1.14 (0.39 to 1.89) | 0.59 (−0.11 to 1.29) | 0.76 (0.14 to 1.37) |
| Per month | |||
| Crude | 0.48 (0.19 to 0.78) | 0.42 (0.13 to 0.72) | 0.44 (0.17 to 0.70) |
| Adjusted | 0.33 (0.03 to 0.63) | 0.31 (0.01 to 0.62) | 0.30 (0.03 to 0.58) |
| Behavior and executive functioning | |||
| Outcome | ADHD symptoms to Conners Third Edition ADHD Index T score (n = 573) | Global executive composite to BRIEF (n = 572) | Total difficulties to SDQ (n = 575) |
| Per 25 mL/kg daily in the NICU | |||
| Crude | −0.96 (−1.81 to −0.10) | −0.45 (−1.09 to 0.19) | −0.26 (−0.58 to 0.06) |
| Adjusted | −1.08 (−1.96 to −0.20) | −0.45 (−1.10 to 0.20) | −0.22 (−0.54 to 0.10) |
| Per monthc | |||
| Crude | −0.20 (−0.51 to 0.10) | −0.08 (−0.28 to 0.12) | −0.06 (−0.17 to 0.05) |
| Adjusted | −0.13 (−0.44 to 0.19) | −0.04 (−0.24 to 0.17) | −0.01 (−0.13 to 0.10) |
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; BRIEF, Behavior Rating Inventory of Executive Function; NICU, neonatal intensive care unit; SDQ, Strengths and Difficulties Questionnaire; WASI, Weschler Abbreviated Scale of Intelligence; WRAT-4, Wide Range Achievement Test, Fourth Edition.
The crude model is unadjusted. The adjusted model is adjusted for treatment, center, maternal tertiary education, maternal occupation, number of adults and children in the home, maternal smoking and alcohol use in pregnancy, parity, race, birth weight (continuous), gestational age (continuous), and antenatal steroid exposure. Generalized estimating equations were used to account for clustering for multiple gestation.
Higher scores on WASI and WRAT-4 indicate more favorable outcomes, whereas lower score on the Conners Third Edition ADHD Index, BRIEF, and SDQ total difficulties scales indicate more favorable outcomes.
Numbers are smaller because of missing data on duration of human milk intake after NICU discharge.