Oropharyngeal colostrum may have limited value in preterm infants

The oropharyngeal administration of colostrum (OAC) appears to be of limited protective efficacy against necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and death among preterm infants, reports a recent meta-analysis.

From the databases of PubMed, CENTRAL, and Embase, researchers retrieved nine randomized controlled trials eligible for inclusion, corresponding to 689 preterm infants. Most of the included studies demonstrated some methodological weakness. One study, for instance, had issues in terms of allocation concealment, while four had issues in terms of outcome blinding.

Pooled analysis of all included studies showed that the rate of NEC in the OAC group was 4.7 percent, lower than the 7.7-percent prevalence in controls. The resulting estimate, however, revealed no significant between-group difference (rate ratio [RR], 0.59, 95 percent confidence interval [CI], 0.33–1.06; p=0.08). This remained robust to subgroup analyses.

Sepsis was reported in 17.8 percent of the OAC infants, and in 24.1 percent of the controls. There was likewise no significant difference between the two groups (RR, 0.78, 95 percent CI, 0.60–1.03; p=0.08), though infants who received OAC were 22-percent less likely to develop LOS.

All-cause mortality was assessed in six studies (n=505), pooled analysis of which revealed an 8.6-percent rate in the OAC group, and a 13.5-percent rate in the control group. Those who received OAC were 37-percent less likely to die of any cause, though statistical significance was not achieved (RR, 0.63, 95 percent CI, 0.38–1.05; p=0.07).

“There is evidence that OAC could not significantly reduce the incidences of NEC, LOS, and death, but there is a trend of positive effects,” the researchers said. “Future studies with large sample sizes and a high quality are needed to confirm the effects of OAC.”