Am J Perinatol. 2025 Jun 2. doi: 10.1055/a-2624-7278. Online ahead of print.
ABSTRACT
OBJECTIVE: To assess the impact of an opt-out consent process compared to the opt-in consent process for using pasteurized donor human milk (PDHM) on feeding practices and growth in preterm neonates.
STUDY DESIGN: A retrospective study of 200 neonates ≤ 28 weeks’ gestation compared the effects of opt-in vs. opt-out consent processes on time to first enteral feed, feeding types, growth trajectories, and prematurity-related morbidities. Descriptive statistics were used to compare the two groups.
RESULTS: The opt-out process did not significantly alter the time to first enteral feed (range opt-in: 0 to 12 days vs. opt-out 0 to 5 days, Mann-Whitney U p=0.295). Compared to the opt-in process, the opt-out process was associated with less formula use, less mother’s milk use, and more PDHM/mixed mom’s milk-PDHM use in the first 4 weeks of life (p<0.01). Unadjusted analyses showed a greater weight gain in the opt-out group on days of life/DOLs 14 and 28 (2.49 [0.20, 4.78] and 3.94 [0.07, 7.80]%, p<0.05), and following adjustment, it remained significant for DOL 14 (1.87 [0.02, 3.71]). Prematurity-related morbidities were similar between the two groups.
CONCLUSION: The opt-out consent process may impart short-term growth benefits in preterm infants. However, long-term outcomes require further study.
PMID:40456284 | DOI:10.1055/a-2624-7278
