Oropharyngeal colostrum in preventing mortality and morbidity in preterm infants.
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ABSTRACT:
SUBMITTER: Nasuf AWA
PROVIDER: S-EPMC6513592 | biostudies-literature | 2018 Sep
REPOSITORIES: biostudies-literature
Publications
Oropharyngeal colostrum in preventing mortality and morbidity in preterm infants.
Nasuf Amna Widad A AWA Ojha Shalini S Dorling Jon J
The Cochrane database of systematic reviews 20180907
<h4>Background</h4>Placing a small volume of colostrum directly onto the buccal mucosa of preterm infants during the early neonatal period may provide immunological and growth factors that stimulate the immune system and enhance intestinal growth. These benefits could potentially reduce the risk of infection and necrotising enterocolitis (NEC) and improve survival and long-term outcome.<h4>Objectives</h4>To determine if early (within the first 48 hours of life) oropharyngeal administration of mo ...[more]
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Project description:BackgroundGlutamine is a conditionally essential amino acid. Endogenous biosynthesis may be insufficient for tissue needs in states of metabolic stress. Evidence exists that glutamine supplementation improves clinical outcomes in critically ill adults. It has been suggested that glutamine supplementation may also benefit preterm infants.ObjectivesTo determine the effects of glutamine supplementation on mortality and morbidity in preterm infants.Search methodsWe used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, 2015, Issue 12), MEDLINE, EMBASE and Maternity and Infant Care (to December 2015), conference proceedings and previous reviews.Selection criteriaRandomised or quasi-randomised controlled trials that compared glutamine supplementation versus no glutamine supplementation in preterm infants at any time from birth to discharge from hospital.Data collection and analysisWe extracted data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by two review authors. We synthesised data using a fixed-effect model and reported typical relative risk, typical risk difference and weighted mean difference.Main resultsWe identified 12 randomised controlled trials in which a total of 2877 preterm infants participated. Six trials assessed enteral glutamine supplementation and six trials assessed parenteral glutamine supplementation. The trials were generally of good methodological quality. Meta-analysis did not find an effect of glutamine supplementation on mortality (typical relative risk 0.97, 95% confidence interval 0.80 to 1.17; risk difference 0.00, 95% confidence interval -0.03 to 0.02) or major neonatal morbidities including the incidence of invasive infection or necrotising enterocolitis. Three trials that assessed neurodevelopmental outcomes in children aged 18 to 24 months and beyond did not find any effects.Authors' conclusionsThe available trial data do not provide evidence that glutamine supplementation confers important benefits for preterm infants.
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