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Volume 5 Journal of Pediatric Care
ISSN: 2471-805X
JOINT EVENT
Neonatology 2019
Pediatrics Surgery 2019
April 23-24, 2019
April 23-24, 2019 London, UK
&
23rd Edition of International Conference on Neonatology and Perinatology
4th International Conference on Pediatrics and Pediatric Surgery
Oropharyngeal colostrum for preterm infants-a systematic review and meta-analysis
Gayatri Athalye-Jape1,2,3, Harshad Panchal1,2,3 and Sanjay Patole 1,3
1King Edward Memorial Hospital, Australia
2Princess Margaret Hospital for Children, Australia
3University of Western Australia, Australia
Administration of oropharyngeal colostrum (OPC) is safe, feasible and potentially beneficial in preterm infants.
We aimed to assess the effects of OPC in preterm infants. A systematic review of randomized controlled
trials (RCTs) and non-RCTs of OPC administration in preterm infants was conducted. We searched MEDLINE
via PubMed and Ovid, EMBASE, Cochrane Central Register of Controlled Trials, Emcare databases, proceedings
of Pediatric Academic Society meetings and grey literature in April 2018. Six RCTs (N=269) and four non-RCTs
(N=737) were included. One RCT (n=40) focused on enteral bovine colostrum and hence was excluded from our
review. Five of the six RCTs had unclear risk of bias in many domains of assessment. Meta-analysis (random effects
model) of RCT data showed no significant difference in ≥stage 2 necrotizing enterocolitis [Relative Risk (RR): 0.83;
95% CI 0.39, 1.75; P=0.62], late onset sepsis [RR: 0.78 (95%CI 0.50, 1.22) P=0.28], all-cause mortality [RR: 0.74 (95%
CI 0.27, 2.06); P=0.56]; duration of hospital stay [Mean Difference (MD): -1.65 days (95% CI: -10.09, 6.80); P=0.70]
and time to full feeds [MD: -2.86 days (95% CI -6.49, 0.77); P=0.12]. Meta-analysis of data from non-RCTs also
showed no benefit for any of these outcomes. OPC increased secretory IgA and lactoferrin levels (four RCTs), but
did not alter oral microbiome (one RCT). There were no adverse effects (e.g. aspiration) of OPC. The overall quality
of evidence (GRADE analysis) was very low. Adequately powered RCTs are needed to confirm the nutritional and
immunomodulatory benefits of OPC in preterm infants.
Biography
Gayatri Jape (MD, FRACP) is a consultant neonatologist at King Edward Memorial Hospital (KEMH) in Perth, WesternAustralia. She is a Clinical Senior Lecturer
at the University of Western Australia. She has worked in Pediatrics and Neonatology since last 15 years in Australia and overseas. Dr Jape is involved in follow
up of high risk preterm infants till five years of age as a part of the Neonatal Follow Up Program at KEMH. She is pursuing a PhD focussed on probiotics,nutrition
and long term neurodevelopment in preterm infants. She led a randomized controlled trial on effect of single or three strain probiotic on enteral nutrition in
extremely preterm infants (SiMPro, ACTRN12615000940572) which is currently in the long term follow up phase. Dr Jape has also completed her Graduate
Certificate in Autism Diagnosis from UWA. She has published articles and is an international reviewer for good impact peer-reviewed journals.
Gayatri Athalye-Jape et al., J Pediatr Care 2019, Volume 5
DOI: 10.21767/2471-805X-C1-021