Article type
Abstract
Components of human colostrum contribute to the maturation of the immune system and intestinal growth in preterm infants, which could help reduce complications related to prematurity such as necrotizing enterocolitis (NEC), intolerance feeding, and survival.
To synthesize and qualify the available information on the effect of oropharyngeal colostrum impregnation (OPC) in the preterm infant to prevent complications and improve perinatal health outcomes.
As part of a process to prioritize questions related to potentially effective interventions for improving the maternal-perinatal health system, focus groups were conducted with experienced physicians and nurses in neonatal care at the Bolivariana University Clinic in Colombia. A priority was placed on understanding the effects of colostrum use in preterm infants on perinatal outcomes. The Mentoring Program of Cochrane US provided training to a mentee and health team in all methodological steps for synthesizing information from evidence-based medicine.
The protocol was registered (osf.io/n9c8m), and a comprehensive search for systematic reviews (SR) examining the PICO question format was conducted. Two independent reviewers assessed SR quality using the AMSTAR-2 tool. A structured summary of findings was prepared, including key concepts such as the applicability of the evidence, potential equity impacts, and economic considerations in middle-income countries and the local setting.
Six SRs were evaluated based on eligibility criteria. A Cochrane SR stood out for its robust methods and high confidence in the results. It found no significant differences with OPC compared with control group in the incidence of NEC, late-onset infection and death before hospital; whereas there was a reduction in the days to full enteral feeds in the OPC group. The overall quality of the primary studies included was low to very low.
Despite the need for more research, OPC's low cost and minimal risk make it a potential option for routine use in preterm infants from middle-income countries. Training personnel in evidence-based medicine synthesis could help address clinical questions efficiently for decision-makers, clinicians, and parents, reducing research waste.
Relevance for patients: Providing colostrum to sick preterm infants is a safe and cost-effective intervention that strengthens the mother's bond with her baby and may improve neonatal outcomes.
To synthesize and qualify the available information on the effect of oropharyngeal colostrum impregnation (OPC) in the preterm infant to prevent complications and improve perinatal health outcomes.
As part of a process to prioritize questions related to potentially effective interventions for improving the maternal-perinatal health system, focus groups were conducted with experienced physicians and nurses in neonatal care at the Bolivariana University Clinic in Colombia. A priority was placed on understanding the effects of colostrum use in preterm infants on perinatal outcomes. The Mentoring Program of Cochrane US provided training to a mentee and health team in all methodological steps for synthesizing information from evidence-based medicine.
The protocol was registered (osf.io/n9c8m), and a comprehensive search for systematic reviews (SR) examining the PICO question format was conducted. Two independent reviewers assessed SR quality using the AMSTAR-2 tool. A structured summary of findings was prepared, including key concepts such as the applicability of the evidence, potential equity impacts, and economic considerations in middle-income countries and the local setting.
Six SRs were evaluated based on eligibility criteria. A Cochrane SR stood out for its robust methods and high confidence in the results. It found no significant differences with OPC compared with control group in the incidence of NEC, late-onset infection and death before hospital; whereas there was a reduction in the days to full enteral feeds in the OPC group. The overall quality of the primary studies included was low to very low.
Despite the need for more research, OPC's low cost and minimal risk make it a potential option for routine use in preterm infants from middle-income countries. Training personnel in evidence-based medicine synthesis could help address clinical questions efficiently for decision-makers, clinicians, and parents, reducing research waste.
Relevance for patients: Providing colostrum to sick preterm infants is a safe and cost-effective intervention that strengthens the mother's bond with her baby and may improve neonatal outcomes.