Nutritional interventions to reduce rates of infection, necrotizing enterocolitis and mortality in very preterm infants

Buehrer, Christoph and Fischer, Hendrik S. and Wellmann, Sven (2020) Nutritional interventions to reduce rates of infection, necrotizing enterocolitis and mortality in very preterm infants. PEDIATRIC RESEARCH, 87 (2). pp. 371-377. ISSN 0031-3998, 1530-0447

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Abstract

Observational studies demonstrating reduced rates of infections, necrotizing enterocolitis (NEC), and mortality in preterm infants fed their own mother's milk, as opposed to formula, have prompted endeavors to achieve similar effects with the right choice of food and food additives. In a systematic review of meta-analyses and randomized controlled trials (RCTs), we considered nutritional interventions aimed at reducing the rates of infections, NEC, or mortality in very preterm infants. The overall effects of particular interventions were presented as risk ratios with 95% confidence intervals. In RCTs, pasteurized human donor milk, as opposed to formula, reduced NEC but not infections or mortality. No differences emerged between infants receiving human or bovine milk-based fortifiers. Pooled data of small trials and a recent large RCT suggested that bovine lactoferrin reduced rates of fungal sepsis without impact on other infections, NEC, or mortality. Pooled data of RCTs assessing the use of prebiotic oligosaccharides found reduced infection but not mortality. Enteral L-glutamine (six RCTs) lowered infection rates, and enteral L-arginine (three RCTs) reduced NEC. A meta-analysis sensitivity approach found multiple-strain (but not single-strain) probiotics to be highly effective in reducing NEC and mortality. Thus, selected food components may help to improve outcomes in preterm infants.

Item Type: Article
Uncontrolled Keywords: BIRTH-WEIGHT INFANTS; LATE-ONSET SEPSIS; MOTHERS OWN MILK; SELENIUM SUPPLEMENTATION; CONTROLLED-TRIAL; PROBIOTICS; METAANALYSIS; FORMULA; RISK; PREVENTION;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Kinder- und Jugendmedizin
Depositing User: Petra Gürster
Date Deposited: 09 Mar 2021 06:26
Last Modified: 09 Mar 2021 06:26
URI: https://pred.uni-regensburg.de/id/eprint/45535

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