Background Oropharyngeal colostrum (OC) is a novel feeding strategy to prevent complications of prematurity. A meta-analysis was conducted to investigate whether very low birth weight infants (VLBWs) can benefit from OC. Methods Randomized controlled trials (RCTs) were searched from Embase, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials from the date of inception until May 2019. RCTs were eligible if they used OC therapy on VLBW infants. The primary outcomes included ventilator-associated pneumonia (VAP), necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), late-onset sepsis, and death. The secondary outcomes included the time of full enteral feeding and the length of stay. Results Eight RCTs involving 682 patients (OC group: 332; non-OC group: 350) were included in the meta-analysis. The results suggested that OC was associated with a significantly reduced incidence of VAP [odds ratio (OR) = 0.39, 95% confidence interval (CI): 0.17–0.88, P = 0.02] and full enteral feeding days (mean difference = −2.66, 95% CI: −4.51 to −0.80, P = 0.005), a potential significance of NEC (OR = 0.51, 95% CI: 0.26–0.99, P = 0.05), a trend toward downregulating mortality (OR = 0.60, 95% CI: 0.34–1.08, P = 0.09) and proven sepsis (OR = 0.64, 95% CI: 0.40–1.01, P = 0.06). Conclusions OC could significantly reduce the occurrence of VAP, and consequently, its routine use should be considered for VLBWs to prevent infectious diseases. Impact OC significantly reduces the occurrence of VAP and NEC in VLBW infants. OC may reduce the incidence of VAP and NEC by increasing IgA levels. Early OC therapy for mechanical ventilation of low-weight infants may prevent the occurrence of VAP.

中文翻译：

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口咽初乳治疗可降低极低出生体重儿呼吸机相关性肺炎的发病率：系统评价和荟萃分析

背景口咽初乳 (OC) 是一种预防早产儿并发症的新型喂养策略。进行了一项荟萃分析，以调查极低出生体重婴儿 (VLBW) 是否可以从 OC 中受益。方法 从 Embase、PubMed、Web of Science 和 Cochrane Central Register of Controlled Trials 检索从开始日期到 2019 年 5 月的随机对照试验 (RCT)。如果 RCT 对 VLBW 婴儿使用 OC 治疗，则符合条件。主要结局包括呼吸机相关性肺炎（VAP）、坏死性小肠结肠炎（NEC）、支气管肺发育不良（BPD）、迟发性败血症和死亡。次要结局包括完全肠内营养的时间和住院时间。结果 8 项随机对照试验涉及 682 名患者（OC 组：332；非 OC 组：350）被纳入荟萃分析。结果表明，OC 与显着降低 VAP 的发生率相关 [优势比 (OR) = 0.39, 95% 置信区间 (CI): 0.17–0.88, P = 0.02] 和全肠内喂养天数（平均差 = -2.66 , 95% CI: -4.51 to -0.80, P = 0.005)，NEC 的潜在意义 (OR = 0.51, 95% CI: 0.26–0.99, P = 0.05)，降低死亡率的趋势 (OR = 0.60, 95 % CI：0.34–1.08，P = 0.09）和确诊的败血症（OR = 0.64，95% CI：0.40–1.01，P = 0.06）。结论 OC可显着降低VAP的发生率，应考虑将其常规用于VLBW以预防传染病。Impact OC 显着降低了 VLBW 婴儿中 VAP 和 NEC 的发生。OC 可通过增加 IgA 水平来降低 VAP 和 NEC 的发生率。