Effects of oropharyngeal administration of colostrum on the incidence of necrotizing enterocolitis, late-onset sepsis, and death in preterm infants: a meta-analysis of RCTs.,European Journal of Clinical Nutrition

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Effects of oropharyngeal administration of colostrum on the incidence of necrotizing enterocolitis, late-onset sepsis, and death in preterm infants: a meta-analysis of RCTs.
European Journal of Clinical Nutrition ( IF 3.6 ) Pub Date : 2020-01-03 , DOI: 10.1038/s41430-019-0552-4
Jiaxin Tao ₁ , Jing Mao ₁ , Jixin Yang ₂ , Yanwei Su ₁

Affiliation

Necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) are two major contributors to death among preterm infants. Oropharyngeal administration of colostrum (OAC) has been proved as an easy, safe, and economically viable technique to help preterm neonates to build up their immunity. In this review, we assessed the effects of OAC on preterm infants. Several mainstream databases were searched including PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and a website of clinical trials. Randomized controlled trials (RCTs) comparing OAC vs. placebo or no intervention in preterm infants (gestation age <34 weeks or birth weight <1500 g) were eligible. Overall, nine RCTs (n = 689) were included in the review. Meta-analysis showed no statistical significance in terms of the incidence of NEC (RR = 0.59, 95% CI = 0.33-1.06, p = 0.08), LOS (RR = 0.78, 95% CI = 0.60-1.03, p = 0.08) and mortality rate (RR = 0.63, 95% CI = 0.38-1.05, p = 0.07). No significant difference was found in the subgroup analysis, apart from the group of the undeveloped region in NEC and mortality. In addition, time was significantly reduced in terms of achieving full enteral feeding (MD = -3.60, 95% CI = -6.55-0.64, p = 0.02) and hospital stay (MD = -10.38, 95% CI = -18.47-2.29, p = 0.01). The results show that OAC does not reduce the incidences of NEC, LOS, and death in preterm infants, but there is a trend toward a positive effect. It is therefore recommended as routine care for preterm infants in the NICU.

中文翻译：

初乳口咽给药对早产儿坏死性小肠结肠炎、迟发性败血症和死亡的影响：一项随机对照试验的荟萃分析。

坏死性小肠结肠炎 (NEC) 和迟发性败血症 (LOS) 是早产儿死亡的两个主要原因。初乳口咽给药 (OAC) 已被证明是一种简单、安全且经济可行的技术，可帮助早产儿增强免疫力。在这篇综述中，我们评估了 OAC 对早产儿的影响。搜索了几个主流数据库，包括 PubMed、EMBASE、Cochrane 对照试验中央注册库 (CENTRAL) 和临床试验网站。比较 OAC 与安慰剂或不干预早产儿（胎龄 <34 周或出生体重 <1500 g）的随机对照试验 (RCT) 符合条件。总体而言，9 项 RCT（n = 689）被纳入评价。Meta 分析显示 NEC 发生率无统计学意义（RR = 0.59, 95% CI = 0.33-1.06, p = 0.08)、LOS (RR = 0.78, 95% CI = 0.60-1.03, p = 0.08) 和死亡率 (RR = 0.63, 95% CI = 0.38-1.05, p = 0.07)。亚组分析除NEC和死亡率不发达地区组外，均无显着差异。此外，实现全肠内营养（MD = -3.60, 95% CI = -6.55-0.64, p = 0.02）和住院时间（MD = -10.38, 95% CI = -18.47-2.29）的时间显着缩短, p = 0.01)。结果表明，OAC 不能降低早产儿 NEC、LOS 和死亡的发生率，但有积极作用的趋势。因此，建议将其作为 NICU 早产儿的常规护理。除了NEC和死亡率的欠发达地区组。此外，实现全肠内营养（MD = -3.60, 95% CI = -6.55-0.64, p = 0.02）和住院时间（MD = -10.38, 95% CI = -18.47-2.29）的时间显着缩短, p = 0.01)。结果表明，OAC 不能降低早产儿 NEC、LOS 和死亡的发生率，但有积极作用的趋势。因此，建议将其作为 NICU 早产儿的常规护理。除了NEC和死亡率的欠发达地区组。此外，实现全肠内营养（MD = -3.60, 95% CI = -6.55-0.64, p = 0.02）和住院时间（MD = -10.38, 95% CI = -18.47-2.29）的时间显着缩短, p = 0.01)。结果表明，OAC 不能降低早产儿 NEC、LOS 和死亡的发生率，但有积极作用的趋势。因此，建议将其作为 NICU 早产儿的常规护理。但有一种积极影响的趋势。因此，建议将其作为 NICU 早产儿的常规护理。但有一种积极影响的趋势。因此，建议将其作为 NICU 早产儿的常规护理。

更新日期：2020-01-04

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