| Title | Enteral Lactoferrin Supplementation for Preventing Sepsis and Necrotizing Enterocolitis in Preterm Infants: A Meta-Analysis With Trial Sequential Analysis of Randomized Controlled Trials |
| Authors | Gao, Ya Hou, Liangying Lu, Cuncun Wang, Qi Pan, Bei Wang, Quan Tian, Jinhui Ge, Long |
| Affiliation | Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China Key Lab Evidence Based Med & Knowledge Translat G, Lanzhou, Peoples R China Lanzhou Univ, Evidence Based Social Sci Res Ctr, Sch Publ Hlth, Lanzhou, Peoples R China Gansu Prov Hosp, Lanzhou, Peoples R China Peking Univ, Peking Univ Peoples Hosp, Dept Gastrointestinal Surg, Beijing, Peoples R China Lanzhou Univ, Sch Publ Hlth, Dept Social Med & Hlth Management, Lanzhou, Peoples R China |
| Keywords | LATE-ONSET SEPSIS BIRTH-WEIGHT INFANTS BOVINE LACTOFERRIN MILK MODULATION IMMUNITY |
| Issue Date | 7-Aug-2020 |
| Publisher | FRONTIERS IN PHARMACOLOGY |
| Abstract | Background Several clinical trials investigated the effects of enteral lactoferrin supplementation on the prevention of sepsis and necrotizing enterocolitis (NEC) in preterm infants, but the efficacy and safety remain disputed. Therefore, we systematically evaluated the effect of enteral lactoferrin supplementation in preterm infants through a meta-analysis with trial sequential analysis (TSA). Methods We searched six databases to identify randomized controlled trials (RCTs) that evaluated the effects of lactoferrin supplementation compared with placebo or no intervention in preterm infants. RevMan version 5.3 software was used to estimate pooled relative risks (RRs) with the random-effects model. TSA, subgroup analyses, and meta-regression analyses were also performed. Results Nine RCTs with 3515 samples were included. With low to moderate quality of evidence, compared with placebo, enteral lactoferrin supplementation did not significantly decrease the incidences of late-onset sepsis (RR = 0.63, 95% CI: 0.38 to 1.02,P= 0.06), NEC stage II or III (RR = 0.68, 95% CI: 0.30 to 1.52,P= 0.35), all-cause mortality (RR = 0.89, 95% CI: 0.51 to 1.57,P= 0.69), bronchopulmonary dysplasia (RR = 1.01, 95% CI: 0.90 to 1.13,P= 0.92), retinopathy of prematurity (RR = 0.80, 95% CI: 0.49 to 1.32,P= 0.38), invasive fungal infection (RR = 0.27, 95% CI: 0.02 to 3.94,P= 0.34), intraventricular hemorrhage (RR = 1.40, 95% CI: 0.39 to 5.08,P= 0.61), and urinary tract infection (RR = 0.35, 95% CI: 0.11 to 1.06,P= 0.06). Subgroup analysis revealed that lactoferrin significantly reduced the incidence of sepsis in infants with a birth weight below 1500 g (RR = 0.43, 95% CI: 0.22 to 0.84,P= 0.01). TSAs of the primary outcomes showed that the evidence is insufficient and further data is required. Conclusions Limited evidence suggested that enteral lactoferrin supplementation was associated with a reduction of late-onset sepsis in infants with a birth weight below 1500g, however, did not decrease the incidence of NEC stage II or III, all-cause mortality, and other adverse events in preterm infants. The present evidence was insufficient to inform clinical practice. |
| URI | http://hdl.handle.net/20.500.11897/591600 |
| ISSN | 1663-9812 |
| DOI | 10.3389/fphar.2020.01186 |
| Indexed | SCI(E) |
| Appears in Collections: | 人民医院 |
