Oropharyngeal Administration Of Colostrum For Preventing Necrotizing Enterocolitis In Preterm Neonates:A Meta-analysis

Objective: To systematically evaluate the efficacy and safety of oropharyngeal administration of colostrum for preventing necrotizing enterocolitis in preterm neonates.Methods: Databases including PubMed,Ovid,EMBASE,The Cochrane Library,CNKI,Wan Fang Data and VIP Data were searched to collect random controlled trails and cohort studies about oropharyngeal administration of colostrum in preterm neonates up to January 2019.Two reviewers independently screened literature,the quality of the included studies was evaluated using a modified version of the Cochrane systematic evaluator manual 5.1.0 or Newcastle-Ottawa Scale which depending on the type of study.Meta-analysis was conducted by Rev Man 5.3 software.Results: A total of 10 studies(1093subjects)were included.Oropharyngeal administration of colostrum was not associated with a statistically significant reduction in the incidence of NEC(OR=0.77,95%CI: 0.46~1.29,P=0.32)and mortality rate(OR=0.69,95%CI: 0.39-1.22,P=0.20),also can't reduce hospital stay(WMD=-6.43,95%CI:-14.70~1.85,P=0.13),but can reduce the time to reach full enteral feed(WMD=-2.23,95%CI:-3.96~-0.50,P=0.01)and antibiotic days(WMD=-2.57,95%CI:-4.13~-1.01,P<0.01).Conclusion: This Meta-analysis showed that oropharyngeal administration of colostrum could not reduce the incidence of NEC and mortality rate in premature infants,and could not shorten the hospitalization days of premature infants.However,it can shorten the time to reach full enteral feed and antibiotic days of hospitalized premature infants,so it is necessary to large samples of high-quality researches to confirm its clinical value in the future.