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The Effect of Oral Immunotherapy on Preterm Neonates: A Promising Adjuvant Therapy in a Clinical Trial Study
Hoda Atef Abdelsattar Ibrahim1,2, Khaled Elkhashab2, Iman Khaled Ayada2
1Pediatric Clinical Nutrition Division, Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt.
Insights
Oropharyngeal colostrum administration in preterm infants significantly reduced hospital stays and sepsis rates. This intervention shows promise as an oral immunotherapy for vulnerable newborns, though it did not impact necrotizing enterocolitis rates.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Immunology
Background:
- Breastfeeding is recommended for all newborns, offering protection against illness and reducing mortality.
- Preterm infants (<34 weeks gestation) have challenges with swallowing and a higher risk of necrotizing enterocolitis (NEC), potentially delaying enteral feeding.
- Oropharyngeal colostrum delivery is explored as a method to mitigate these issues.
Purpose of the Study:
- To investigate the impact of oropharyngeal colostrum delivery on hospital outcomes in preterm neonates (<34 weeks gestation).
- To compare hospital stay duration between neonates receiving 3 days of oropharyngeal colostrum versus those receiving none.
Main Methods:
- A prospective, randomized controlled trial involving 96 preterm neonates.
- Three groups were established: 3 days of oropharyngeal colostrum, 10 days of oropharyngeal colostrum, and routine care only.
- Statistical analysis included Kruskal-Wallis and chi-squared tests.
Main Results:
- Neonates receiving oropharyngeal colostrum (3 or 10 days) had significantly shorter hospital stays, faster achievement of full enteral intake, and lower sepsis rates compared to the control group (p < 0.001).
- Daily weight gain was significantly different between the control group and the 10-day colostrum group (p = 0.028).
- No significant difference in necrotizing enterocolitis (NEC) incidence was observed among the groups (p = 0.314).
Conclusions:
- Oropharyngeal colostrum administration may serve as a beneficial oral immunotherapy for preterm neonates.
- This intervention demonstrates potential for improving key hospital outcomes in this vulnerable population.
Introduction:
Breastfeeding is currently recommended as the optimal and initial feeding option for all newborns, as it protects against illness and reduces neonatal mortality. Furthermore, premature infants exhibit reduced swallowing ability and an increased risk of developing necrotizing enterocolitis (NEC), which may hinder suckling and delay the initiation of enteral feeding. Our aim was to investigate the effects of oropharyngeal colostrum delivery in preterm neonates <34 weeks of gestation on hospital outcomes, specifically differences in hospital stay between neonates who received colostrum for 3 days and those who did not.
Methods:
This prospective, interventional, randomized controlled trial enrolled ninety-six preterm neonates, who were allocated into three groups: group A, neonates who received oropharyngeal colostrum for 3 days along with routine care; group B, neonates who received oropharyngeal colostrum for 10 days along with routine care; and group C, neonates who received routine care only. The Kruskal-Wallis test was used to compare medians among the three groups. Associations between categorical variables were analyzed using the chi-squared test and Monte Carlo test.
Results:
The two groups that received colostrum showed significantly reduced median hospital stays, time to reach full enteral intake, and sepsis rates compared to the control group (p < 0.001). A significant difference in daily weight gain was observed between groups, particularly between the control group and neonates who received colostrum for 10 days (p = 0.028). Regarding the incidence of NEC, no significant difference was found among the groups (p = 0.314).
Conclusion:
Oropharyngeal colostrum may be considered a potential oral immunotherapy.
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