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Effect of oropharyngeal colostrum therapy in the prevention of necrotising enterocolitis among very low birthweight neonates: A meta‐analysis of randomised controlled trials
Author(s) -
Garg B. D.,
Balasubramanian H.,
Kabra N. S.,
Bansal A.
Publication year - 2018
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/jhn.12585
Subject(s) - medicine , colostrum , relative risk , meta analysis , necrotizing enterocolitis , randomized controlled trial , confidence interval , gestational age , placebo , incidence (geometry) , pediatrics , clinical trial , pregnancy , physics , alternative medicine , antibody , pathology , biology , optics , immunology , genetics
Abstract Background Necrotising enterocolitis ( NEC ) is one of the most common life‐threatening emergencies of the gastrointestinal tract in preterm neonates. The present study aimed to determine the efficacy of oropharyngeal colostrum with respect to reducing NEC in preterm neonates. Methods A literature search was conducted for various randomised control trials by searching the Cochrane Central Register of Controlled Trials, PubMed, EMBASE and ongoing clinical trials. Randomised or quasi‐randomised trials comparing oropharyngeal colostrum versus placebo in neonates (birthweight ≤ 1500 g or gestational age ≤ 32 weeks) were included in the review. The methodological quality of each trial was independently reviewed by the authors. For categorical and continuous variables, typical estimates for relative risk and typical estimates for weighted mean difference were calculated, respectively. A random effect model was assumed for meta‐analysis. Results In total, four eligible trials were included in the review. Oropharyngeal colostrum therapy was not associated with a statistically significant reduction in the incidence of NEC stage ≥2 [typical relative risk ( RR ) = 0.64; 95% confidence interval ( CI ) = 0.27–1.49], mortality from any cause (typical RR = 0.86; 95% CI = 0.15–4.80) and time to reach full feed [typical weighted mean difference (WMD) = −3.26; 95% CI = −8.87 to 2.35]. Duration of hospital stay was significantly less in the control group (typical WMD = 9.77; 95% CI = 3.96–15.59). Conclusions The current evidence is insufficient for recommending oropharyngeal colostrum as a routine clinical practice in the prevention of NEC . We emphasise the need for large randomised controlled trials with an adequate sample size and validated clinical outcomes in preterm neonates.