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Prophylactic lactoferrin for preventing late-onset sepsis and necrotizing enterocolitis in preterm infants: A

Yi He1, Luying Cao, Jialin Yu

  • 1Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Yuzhong China International Science and Technology Cooperation Base of Child Development and Critical Disorders Chongqing Key Laboratory of Pediatrics, Chongqing, China.

Medicine
|September 2, 2018
PubMed

Insights

Prophylactic lactoferrin supplementation significantly reduces late-onset sepsis and necrotizing enterocolitis in preterm infants. This intervention also lowers hospital-acquired infections and infection-related mortality without adverse effects.

Area of Science:

  • Neonatal Medicine
  • Microbiome Research
  • Immunology

Background:

  • Prophylactic strategies for preterm infants' gut microbiota and immune systems are debated.
  • Lactoferrin is a promising supplement, but its efficacy and safety for preventing late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) remain controversial.

Purpose of the Study:

  • To evaluate the effect and safety of lactoferrin supplementation in preventing LOS and NEC in preterm infants.
  • To synthesize evidence from randomized controlled trials (RCTs) through meta-analysis.

Main Methods:

  • Searched multiple databases (Medline, Embase, Cochrane Library, etc.) for English and Chinese RCTs.
  • Included 9 RCTs involving 1834 preterm infants.
  • Conducted meta-analysis using Rev Man 5.3 software with random-effects models.

Main Results:

  • Lactoferrin significantly reduced the incidence of culture-proven LOS (RR 0.47) and NEC (stage II or more) (RR 0.40).
  • Associated with decreased hospital-acquired infections (RR 0.47) and a trend towards reduced infection-related mortality (RR 0.24).
  • Shortened time to full enteral feeding (WMD -2.11 days) with no significant effect on all-cause mortality.

Conclusions:

  • Lactoferrin supplementation effectively reduces NEC and LOS incidence in preterm infants.
  • It also decreases hospital-acquired infections and infection-related mortality.
  • No obvious adverse effects were reported in the included trials.
Abstract

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