Oropharyngeal Colostrum for Preterm Infants: A Systematic Review and Meta-Analysis.
Colostrum
Enteral Nutrition
/ methods
Enterocolitis, Necrotizing
/ epidemiology
Feeding Methods
Humans
Infant Nutritional Physiological Phenomena
Infant, Newborn
Infant, Premature
/ growth & development
Infant, Premature, Diseases
/ epidemiology
MEDLINE
Non-Randomized Controlled Trials as Topic
Oropharynx
Randomized Controlled Trials as Topic
human colostrum
meta-analysis
oropharyngeal colostrum
preterm infants
systematic review
Journal
Advances in nutrition (Bethesda, Md.)
ISSN: 2156-5376
Titre abrégé: Adv Nutr
Pays: United States
ID NLM: 101540874
Informations de publication
Date de publication:
01 11 2019
01 11 2019
Historique:
pubmed:
31
5
2019
medline:
4
7
2020
entrez:
1
6
2019
Statut:
ppublish
Résumé
Administration of oropharyngeal colostrum (OPC) is safe, feasible, and potentially beneficial in preterm infants. We aimed to assess the effects of OPC in preterm infants. A systematic review of randomized controlled trials (RCTs) and non-RCTs of OPC administration in preterm infants was conducted. We searched MEDLINE via PubMed and Ovid, EMBASE, the Cochrane Central Register of Controlled Trials, Emcare databases, abstracts of Pediatric Academic Societies meetings, and gray literature in April 2018. Six RCTs (n = 269) and 4 non-RCTs (n = 737) were included. One RCT (n = 40) focused on enteral bovine colostrum and hence was excluded from our review. Five of the 6 RCTs had unclear risk of bias in many domains of assessment. Meta-analysis (random effects model) of RCT data showed no significant difference in ≥stage 2 necrotizing enterocolitis (RR: 0.83; 95% CI: 0.39, 1.75; P = 0.62), late-onset sepsis (RR: 0.78; 95% CI: 0.50, 1.22; P = 0.28), all-cause mortality (RR: 0.74; 95% CI: 0.27, 2.06; P = 0.56); duration of hospital stay (mean difference [MD]: -1.65 d; 95% CI: -10.09, 6.80; P = 0.70), and time to full feeds (MD: -2.86 d; 95% CI: -6.49, 0.77; P = 0.12). Meta-analysis of data from non-RCTs also showed no benefit for any of these outcomes. OPC increased secretory IgA and lactoferrin concentrations (4 RCTs), and had only a transient effect on the oral microbiome (1 RCT). There were no adverse effects (e.g., aspiration) of OPC. The overall quality of evidence (Grades of Recommendation, Assessment, Development, and Evaluation analysis) was very low. Adequately powered RCTs are needed to confirm the nutritional and immunomodulatory benefits of OPC in preterm infants.
Identifiants
pubmed: 31147686
pii: S2161-8313(22)00438-0
doi: 10.1093/advances/nmz033
pmc: PMC6855966
doi:
Banques de données
ClinicalTrials.gov
['NCT03513146']
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1152-1162Informations de copyright
Copyright © American Society for Nutrition 2019.
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