|
|
Effect of colostrum on immunoglobulin A levels among premature infants: a meta-analysis |
MEN Guangguo1, LU Xudan1, WANG Lili2
|
1. Neonatal Center of Ningbo Women and Children's Hospital, Ningbo, Zhejiang 315012, China; 2. Dong'e Hospital of Traditional Chinese Medicine, Liaocheng, Shandong 252201, China |
|
|
Abstract Objective To systematically evaluate the effect of colostrum on immunoglobulin A (IgA) levels among premature infants, so as to provide the evidence for improving premature infants' health with colostrum feeding. Methods Randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs) pertaining to the effect of colostrum and IgA levels among premature infants were retrieved in national and international databases from inception to September 30, 2022, including CNKI, Wanfang Data, PubMed and Web of Science. Standardized mean difference (SMD) was used as an effect index for meta-analysis. The robustness of the results was evaluated using sensitivity analysis, and the publication bias was evaluated using Begg's test, Egger's test and funnel plot. Results A total of 650 publications were retrieved initially, and 10 studies were finally included, including 9 RCTs and one1 CCT, with 677 participants. Meta-analysis showed higher secretory salivary secretory IgA levels among premature infants with colostrum feeding than among controls (SMD=0.49, 95%CI: 0.08-0.89), and there were no significant differences between groups in terms of urinary secretory IgA levels (SMD=0.19, 95%CI: -0.39-0.77) or blood IgA levels (SMD=0.29, 95%CI: -0.01-0.59). Sensitivity analysis showed robustness of meta-analysis results, and no publication bias was examined. Conclusion Colostrum feeding may increase salivary secretory IgA levels among premature infants; however, it has no effect on urine salivary secretory IgA levels or blood IgA levels.
|
Received: 31 January 2023
Revised: 18 March 2023
Published: 15 May 2023
|
|
|
|
|
[1] KATZ J,LEE A C,KOZUKI N,et al.Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries:a pooled country analysis[J].Lancet,2013,382(9890):417-425. [2] PERIN J,MULICK A,YEUNG D,et al.Global,regional,and national causes of under-5 mortality in 2000-19:an updated systematic analysis with implications for the Sustainable Development Goals[J].Lancet Child Adolesc Health,2022,6(2):106-115. [3] CHAWANPAIBOON S,VOGEL J P,MOLLER A B,et al.Global,regional,and national estimates of levels of preterm birth in 2014:a systematic review and modelling analysis[J].Lancet Glob Health,2019,7(1):37-46. [4] BALLARD O,MORROW A L.Human milk composition:nutrients and bioactive factors[J].Pediatr Clin North Am,2013,60(1):49-74. [5] LEE J,KIM H S,JUNG Y H,et al.Oropharyngeal colostrum administration in extremely premature infants:an RCT[J].Pediatrics,2015,135(2):357-366. [6] FERREIRA D M L M,OLIVEIRA A M M,DE LEVES D V,et al.Randomized controlled trial of oropharyngeal colostrum administration in very-low-birth-weight preterm infants[J].J Pediatr Gastroenterol Nutr,2019,69(1):126-130. [7] GLASS K M,GREECHER C P,DOHENY K K.Oropharyngeal administration of colostrum increases salivary secretory IgA levels in very low-birth-weight infants[J].Am J Perinatol,2017,34(14):1389-1395. [8] 刘杰,陈丽莲,穆晓和,等.初乳口腔涂抹对管饲超低/极低出生体重儿唾液中sIgA含量的影响[J].中华新生儿科杂志,2022,37(5):418-422. [9] MORENO-FERNANDEZ J,SÁNCHEZ-MARTÍNEZ B,SERRANO-LÓPEZ L,et al.Enhancement of immune response mediated by oropharyngeal colostrum administration in preterm neonates[J].Pediatr Allergy Immunol,2019,30(2):234-241. [10] ROMANO-KEELER J,AZCARATE-PERIL M A,WEITKAMP J H,et al.Oral colostrum priming shortens hospitalization without changing the immunomicrobial milieu[J].J Perinatol,2017,37(1):36-41. [11] ROMERO-MALDONADO S,SORIANO-BECERRIL D M,GARCÍA-MAY P K,et al.Effect of oropharyngeal administration of colostrum in premature newborns ≤32 weeks of gestation on the immune response and neonatal morbidity:a double-blind randomized clinical trial[J/OL].Front Pediatr,2022,10[2023-03-18] .https://doi.org/10.3389/fped.2022.891491. [12] SUDEEP K C,KUMAR J,RAY S,et al.Oral application of colostrum and mother's own milk in preterm infants:a randomized,controlled trial[J].Indian J Pediatr,2022,89(6):579-586. [13] ZHANG Y,JI F,HU X,et al.Oropharyngeal colostrum administration in very low birth weight infants:a randomized controlled trial[J].Pediatr Crit Care Med,2017,18(9):869-875. [14] 李秋芳,王华,柳珍月,等.极低和超低出生体重儿舌下黏膜涂抹亲母初乳的免疫效果研究[J].中华护理杂志,2018,53(12):1424-1428. [15] DIMITROGLOU M,ILIODROMITI Z,CHRISTOU E,et al.Human breast milk:the key role in the maturation of immune,gastrointestinal and central nervous systems:a narrative review[J].Diagnostics(Basel),2022,12(9):1-16. [16] 李彩荣,金宇婷,华春珍. 早期母乳中免疫球蛋白和补体含量动态观察[J].浙江预防医学,2015,27(3):308-309,312. [17] 周勤,陶亚琴,李萍,等.初乳口腔免疫治疗对极低出生体重儿临床预后影响的研究[J].中国儿童保健杂志,2018,26(11):1189-1193. |
|
|
|