Oropharyngeal administration of colostrum for preventing necrotizing enterocolitis and late-onset sepsis in preterm infants with gestational age ≤ 32 weeks: a pilot single-center randomized controlled trial

Ouyang, Xia; Yang, Changyi; Xiu, Wenlong; Hu, Yanhua; Mei, Su-Su; Lin, Qin

doi:10.1186/s13006-021-00408-x

Cited by 35 publications

(61 citation statements)

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“…Intraventricular hemorrhage is a common type of intracranial hemorrhage in preterm infants, and it is also one of the main causes of death and disability in preterm infants. In total, 4 studies ( 4 , 5 , 7 , 13 ) reported the incidence of IVH (grade ≥3) in 645 preterm infants ( Figure 11 ). The incidence of IVH in the colostrum group (grade ≥3) was 2.2% (7/315) and in the control group was 5.2% (17/330).…”

Section: Resultsmentioning

confidence: 99%

“…The most serious outcome is PVL, which causes neurological sequelae in children. In total, 2 studies ( 5 , 8 ), with a total sample of 369 preterm infants, measured the incidence of PVL ( Figure 12 ). The incidence of PVL in the colostrum group was 1.1% (2/186) and in the control group was 1.6% (3/183).…”

Section: Resultsmentioning

confidence: 99%

“…Retinopathy of prematurity is an important disease that leads to blindness or severe visual impairment in preterm infants. In total, 5 studies ( 4 , 5 , 7 , 8 , 13 ), with a total sample of 762 preterm infants, measured the incidence of ROP ( Figure 13 ). The incidence of ROP in the colostrum group was 11.0% (41/374) and in the control group was 5.8% (34/588).…”

Section: Resultsmentioning

confidence: 99%

“…It was found that a strategy of OAC in very preterm and extremely preterm infants did not decrease the composite primary outcome of death, LOS, or NEC ( 4 ). However, a randomized controlled study in China shows that for the preterm infants with gestation age (GA) ≤ 32 weeks, OAC yields a potential effect in decreasing the incidences of NEC, LOS, and severe intraventricular hemorrhage (IVH) ( 5 ). In view of the great differences between the results of various studies, a relatively unified opinion has not yet been formed, this study intends to systematically retrieve and evaluate the impact of OAC on preterm infants, which is expected to be helpful to neonatologists in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

“…11 RCTs met the inclusion criteria of this review. Among them, 581 in colostrum group and 592 in control group, a total of 1,173 preterm infants were included(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The study selection process is shown in Figure1.…”

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confidence: 99%

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Intervention Effect of Oropharyngeal Administration of Colostrum in Preterm Infants: A Meta-Analysis

et al. 2022

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ObjectiveTo evaluate the efficacy and safety of oropharyngeal administration of colostrum (OAC) in preterm infants.MethodsWe searched Embase, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the website of the clinical trials, search time was from the establishment of the databases or websites up to 1 February 2022. Preterm infants with gestational age (GA) ≤ 32 weeks or birth weight (BW) ≤ 1500 g were taken as the participants, collect randomized controlled trials (RCTs) of comparing OAC and placebo or no intervention in preterm infants. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature, and we adopted Review Manager 5.3 software for meta-analysis.ResultsIn total, 11 RCTs (n = 1,173) were included in the review. A meta-analysis showed significant difference in the incidence of necrotizing enterocolitis [NEC; p = 0.009, relative ratio (RR) = 0.51, 95% confidence interval (CI) = 0.31–0.84], late-onset sepsis (LOS; p = 0.02, RR = 0.75, 95% CI = 0.59–0.95), ventilator-associated pneumonia (VAP; p = 0.03, RR = 0.48, 95% CI = 0.24–0.95), the time to reach full enteral feeds (p < 0.00001, mean difference (MD) = −3.40, 95% CI = −3.87 to −2.92), duration of hospital stay (p < 0.00001, MD = −10.00, 95% CI = −11.36 to −8.64), and the rate of weight gain (kg.d; p < 0.00001, MD = 2.63, 95% CI = 2.10–3.16) between the colostrum group and control group. Meanwhile, researchers found no significant difference between the colostrum group and control group in the incidence of bronchopulmonary dysplasia (BPD; p = 0.17, RR = 0.83, 95% CI = 0.64–1.08), intraventricular hemorrhage (IVH; grade ≥3; p = 0.05, RR = 0.44, 95% CI = 0.19–1.01), periventricular leukomalacia (PVL; p = 0.67, RR = 0.70, 95% CI = 0.14–3.49), retinopathy of prematurity (ROP; p = 0.29, RR = 1.25, 95% CI = 0.82–1.89), and patent ductus arteriosus (PDA; p = 0.17, RR = 1.22, 95% CI = 0.92–1.62).ConclusionOropharyngeal administration of colostrum can reduce the incidence of NEC, LOS, and VAP in preterm infants, shortening the time to reach full enteral feeds, and duration of hospital stay, and increasing the rate of weight gain (kg.d). Therefore, OAC can be used as part of routine care for preterm infants.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Intervention Effect of Oropharyngeal Administration of Colostrum in Preterm Infants: A Meta-Analysis

et al. 2022

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Effect of oropharyngeal colostrum therapy on neonatal sepsis in preterm neonates: A systematic review and meta‐analysis

Anne,

Kumar,

Kumar

et al. 2023

J. pediatr. gastroenterol. nutr.

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Various studies have shown that oropharyngeal colostrum application (OPCA) is beneficial to preterm neonates. We performed a systematic review and meta‐analysis to assess whether OPCA reduces the incidence of culture‐proven neonatal sepsis in preterm neonates. Randomized controlled trials comparing OPCA with placebo or standard care in preterm neonates were included. Medline, Embase, Web of Science, Cumulated Index to Nursing and Allied Health Literature, Scopus, and CENTRAL were searched for studies published up to June 15, 2023. We used the Cochrane Risk of Bias tool, version 2, for risk of bias assessment, the random‐effects model (RevMan 5.4) for meta‐analysis, and Gradepro software for assessing the certainty of evidence. Twenty‐one studies involving 2393 participants were included in this meta‐analysis. Four studies had a low risk of bias, whereas seven had a high risk. Oropharyngeal colostrum significantly reduced the incidence of culture‐proven sepsis (18 studies, 1990 neonates, risk ratio [RR]: 0.78, 95% confidence interval [95% CI]: 0.65, 0.94), mortality (18 studies, 2117 neonates, RR: 0.73, 95% CI: 0.59, 0.90), necrotizing enterocolitis (NEC) (17 studies, 1692 neonates, RR: 0.59, 95% CI: 0.43, 0.82), feeding intolerance episodes (four studies, 445 neonates, RR: 0.59, 95% CI: 0.38, 0.92), and the time to full enteral feeding (19 studies, 2142 neonates, mean difference: −2 to 21 days, 95% CI: −3.44, −0.99 days). There was no reduction in intraventricular hemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia, ventilator‐associated pneumonia, neurodevelopmental abnormalities, hospital stay duration, time to full oral feeding, weight at discharge, pneumonia, and duration of antibiotic therapy. The certainty of the evidence was high for the outcomes of culture‐positive sepsis and mortality, moderate for NEC, low for time to full enteral feeding, and very low for feeding intolerance. OPCA reduces culture‐positive sepsis and mortality (high certainty), NEC (moderate certainty), and time to full enteral feeding (low certainty) in preterm neonates. However, scarcity of data from extremely premature infants limits the generalizability of these results to this population.

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Neonatale Infektionen

Pirr

Viemann

2023

Monatsschr Kinderheilkd

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Oropharyngeal administration of colostrum for preventing necrotizing enterocolitis and late-onset sepsis in preterm infants with gestational age ≤ 32 weeks: a pilot single-center randomized controlled trial

Cited by 35 publications

References 44 publications

Intervention Effect of Oropharyngeal Administration of Colostrum in Preterm Infants: A Meta-Analysis

Intervention Effect of Oropharyngeal Administration of Colostrum in Preterm Infants: A Meta-Analysis

Effect of oropharyngeal colostrum therapy on neonatal sepsis in preterm neonates: A systematic review and meta‐analysis

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