{"title":"Oropharyngeal Colostrum Administration in Premature Infants: Impact on Immune Status and Incidence of Common Morbidities.","authors":"Majid Mohammadizadeh, Azadeh Jafari, Behzad Barekatain","doi":"10.4103/ijpvm.ijpvm_132_23","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Enteral feeding of preterm infants with maternal colostrum has well-known effects on protecting them, especially against serious infections. This study was conducted to determine whether oropharyngeal administration of colostrum to these infants, soon after birth, has any additional effect on their clinical outcomes and stimulation of their immune system.</p><p><strong>Methods: </strong>In this double-blind randomized clinical trial, 60 preterm infants ≤30 weeks' gestation with birth weight ≤1500 g were randomly assigned to receive oropharyngeal colostrum (OAC group) or distilled water (DW group). Primary outcomes were urinary concentration of IgA on days 1, 8, and 15 of birth and incidence of late onset sepsis (LOS) and necrotizing enterocolitis (NEC). Data were analyzed by independent samples <i>t</i>-test, repeated measures ANOVA, and Chi-square test using SPSS v. 25.</p><p><strong>Results: </strong>The frequency of LOS, NEC, CLD, and mortality and the mean duration of hospitalization and the time to reach full enteral feeding were similar in both groups (<i>P</i> > 0.05). The mean of urinary IgA levels increased significantly from the 1<sup>st</sup> day of birth to the 15<sup>th</sup> day of birth in the OAC group (<i>P</i> = 0.013) but decreased significantly from the 1<sup>st</sup> day of birth to the 8<sup>th</sup> and 15<sup>th</sup> days of birth in the DW group (<i>P</i> = 0.04). Results of repeated measures ANOVA test regarding the impact of the two interventions during the studied times on the level of IgA showed that the differences between the means were statistically significant [F (2,116) = 5.12, <i>P</i> = 0.007].</p><p><strong>Conclusions: </strong>Oropharyngeal administration of colostrum within the first days of life in preterm infants increases the concentration of IgA in urine. The impact of this immune response on common morbidities of these infants, particularly extremely low gestational age neonates, still needs to be investigated more in other larger studies.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"62"},"PeriodicalIF":1.7000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687677/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Preventive Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ijpvm.ijpvm_132_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Enteral feeding of preterm infants with maternal colostrum has well-known effects on protecting them, especially against serious infections. This study was conducted to determine whether oropharyngeal administration of colostrum to these infants, soon after birth, has any additional effect on their clinical outcomes and stimulation of their immune system.
Methods: In this double-blind randomized clinical trial, 60 preterm infants ≤30 weeks' gestation with birth weight ≤1500 g were randomly assigned to receive oropharyngeal colostrum (OAC group) or distilled water (DW group). Primary outcomes were urinary concentration of IgA on days 1, 8, and 15 of birth and incidence of late onset sepsis (LOS) and necrotizing enterocolitis (NEC). Data were analyzed by independent samples t-test, repeated measures ANOVA, and Chi-square test using SPSS v. 25.
Results: The frequency of LOS, NEC, CLD, and mortality and the mean duration of hospitalization and the time to reach full enteral feeding were similar in both groups (P > 0.05). The mean of urinary IgA levels increased significantly from the 1st day of birth to the 15th day of birth in the OAC group (P = 0.013) but decreased significantly from the 1st day of birth to the 8th and 15th days of birth in the DW group (P = 0.04). Results of repeated measures ANOVA test regarding the impact of the two interventions during the studied times on the level of IgA showed that the differences between the means were statistically significant [F (2,116) = 5.12, P = 0.007].
Conclusions: Oropharyngeal administration of colostrum within the first days of life in preterm infants increases the concentration of IgA in urine. The impact of this immune response on common morbidities of these infants, particularly extremely low gestational age neonates, still needs to be investigated more in other larger studies.
期刊介绍:
International Journal of Preventive Medicine, a publication of Isfahan University of Medical Sciences, is a peer-reviewed online journal with Continuous print on demand compilation of issues published. The journal’s full text is available online at http://www.ijpvmjournal.net. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal will cover technical and clinical studies related to health, ethical and social issues in field of Preventive Medicine. Articles with clinical interest and implications will be given preference.