Enteral Lactoferrin Supplementation For Prevention Of Late-onset Sepsis In Preterm Infants: A Meta Analysis

Background: lactoferrin is the main whey protein in mammalian milk,which can enhance the defense ability of the host.Maybe it can effective prevention of late-onset sepsis in premature infants.Objective: To evaluate the efficacy and safety of lactoferrin in the prevention of late-onset sepsis in premature infants.Methods: Retrieval of PubMed,Ovid-Embase,The Cochrane Library,Chinese Journal Full-text Database,Chinese Journal Database,Chinese Biomedical Literature Database,and WanFang Database.The bias risk of the inclusion literature was evaluated by the Cochrane Handbook5.0literature quality evaluation standard,and the data was analyzed with software RevMan5.3.Results: Eight randomized controlled trials were included in a total of1137 premature infants.Meta analysis showed that the main results were as follows:(1)LF can reduce the incidence of LOS in premature infants(RR =0.45,95%CI: 0.31-0.64,P<0.00001);LF +LGG may also reduce theincidence of LOS in premature infants(RR = 0.24,95%CI: 0.13-0.44,P<0.00001);(2)Compared with the control group,there was no statistical difference in the all-cause mortality of premature infants in LF group and LF+LGG group(RR = 0.88,95%CI: 0.51-1.52,P=0.65).RR = 0.59,95%CI:0.28-1.25,P=0.17);(3)Compared with the control group,LF group and LF+LGG group could reduce the incidence of LOS related mortality.(RR=0.08,95%CI: 0.02-0.43;RR=0.16,95%CI: 0.04-0.72,P=0.02).None of the randomized controlled trials were reported on adverse reactions of oral lactoferrin in premature infants.Conclusion:LF combined or not combined with LGG can reduce the incidence rate of late-onset sepsis the incidence of LOS related mortality,but cannot reduce all-cause mortality of premature infants..But given into research between heterogeneity and bias,insufficient sample size and number included in the study,still need to be more large multicenter clinical trial to evaluate its effectiveness,safety,and assess the prognosis of children with nervous system development.