Oropharyngeal Colostrum Administration in Premature Infants: Impact on Immune Status and Incidence of Common
Majid Mohammadizadeh1, Azadeh Jafari1, Behzad Barekatain1
1Department of Pediatrics, School of Medicine and Child Health Promotion Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Oropharyngeal colostrum administration to preterm infants boosted urinary IgA levels. However, this method did not significantly alter clinical outcomes like sepsis or necrotizing enterocolitis in this study.
Area of Science:
- Neonatal immunology
- Pediatric gastroenterology
- Clinical trial research
Background:
- Maternal colostrum feeding offers protection to preterm infants, particularly against infections.
- The study investigates the potential additional benefits of oropharyngeal colostrum administration in preterm infants.
- Focus is on immune system stimulation and clinical outcomes.
Purpose of the Study:
- To evaluate the effect of oropharyngeal colostrum on urinary IgA levels in preterm infants.
- To assess the impact of oropharyngeal colostrum on the incidence of late onset sepsis (LOS) and necrotizing enterocolitis (NEC).
- To determine if oropharyngeal colostrum influences other clinical outcomes such as duration of hospitalization and time to full enteral feeding.
Main Methods:
- A double-blind randomized clinical trial involving 60 preterm infants (≤30 weeks gestation, ≤1500 g birth weight).
- Infants were assigned to receive either oropharyngeal colostrum (OAC) or distilled water (DW).
- Primary outcomes included urinary IgA concentration, LOS, and NEC incidence, analyzed using t-tests, ANOVA, and Chi-square tests.
Main Results:
- Urinary IgA levels significantly increased from day 1 to day 15 in the OAC group (P=0.013).
- Urinary IgA levels significantly decreased from day 1 to days 8 and 15 in the DW group (P=0.04).
- No significant differences were observed between groups in the incidence of LOS, NEC, CLD, mortality, hospitalization duration, or time to full enteral feeding (P > 0.05).
Conclusions:
- Oropharyngeal colostrum administration in preterm infants enhances urinary IgA concentration.
- The clinical impact of this immune response on common neonatal morbidities requires further investigation in larger studies.
- Larger studies are needed to confirm the benefits for extremely low gestational age neonates.
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.
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