Enteral Lactoferrin Supplementation for Very Preterm Infants: A Randomised Controlled Trial

Griffiths, James; Jenkins, Patricia; Vargova, Monika; Bowler, Ursula; Juszczak, Edmund; King, Andrew; Linsell, Louise; Murray, David R.; Partlett, Christopher; Berrington, Janet; Dorling, Jon; Embleton, Nicholas; Heath, Paul T.; Oddie, Sam; McGuire, William

doi:10.2139/ssrn.3234862

Cited by 2 publications

(4 citation statements)

References 18 publications

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“…The study by ELFIN stated that lactoferrin supplementation (150 mg/kg/day) for 34 weeks did not reduce the risk of LOS, NEC, and mortality in premature infants. It was also reported that the incidence of NEC and mortality was lower in control than in the enteral lactoferrin supplementation group 16 . Sherman et al showed that the mortality rate was higher in the enteral lactoferrin supplementation group 25 .…”

Section: Bmentioning

confidence: 87%

“…However, this could be due to the largest RCT study with contradictory results. ELFIN reported that NEC incidence was more significant in the enteral lactoferrin supplementation group than in the control group 16 . The sensitivity test was performed by excluding ELFIN 2019.…”

Section: Discussionmentioning

confidence: 98%

“…The mechanism of action was associated with the protein's capability to bind to iron. Lactoferrin could act as antimicrobial, antiviral, antifungal, and immunomodulatory agents to prevent sepsis and mortality 16 . It directly binds with bacterial lipopolysaccharides (LPS) to inhibit the interaction between endotoxin-containing LPS binding protein (LBP) and CD14, which is essential to prevent the pathogenesis of sepsis 28 .…”

Section: Discussionmentioning

confidence: 99%

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Meta-Analysis of Enteral Lactoferrin Supplementation for Reducing the Risk of Preterm Infants Sepsis

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Tanuwijaya²

2022

SMedJour

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Introduction: Severe COVID-19 in pregnancy is strongly associated with preterm infant late-onset sepsis (LOS), which is a major cause of morbidity and mortality in infants. Recently, Lactoferrin, an iron-binding protein significantly discovered in human colostrum, shows potential effect on reducing the risk of preterm infant LOS and mortality by its immunomodulatory properties. Therefore, this study aimed to evaluate the effect of Lactoferrin on reducing the risk of preterm LOS, necrotizing enterocolitis (NEC), and mortality in preterm infants. Methods: This study followed the guidelines provided by PRISMA. A literature search was conducted with PubMed, Cochrane Library, Google Scholar, and ScienceDirect. The combined effect of LOS, NEC and mortality incidence were presented as risk ratios (RR) with a 95% confidence interval (CI) using a random-effects model (REM) or fixed-effects model (FEM) forest plot. Furthermore, the heterogeneity level was checked by I2 and the p-value of the chi2 test. Results: The incidence of LOS was significantly higher in the control than lactoferrin supplementation group [RR=0.65, 95% CI (0.56,0.77), p<0.00001, I2=56%]. However, there were no significant differences in NEC [RR=0.80, 95% CI (0.63,1.02), p=0.10, I2=39%] and mortality [RR=0.94, 95% CI (0.77,1.13), p=0.49, I2=39%], despite the trends are higher in the control group. Conclusion: This meta-analysis showed that enteral lactoferrin supplementation in preterm infants was associated with a significant reduction in LOS, but not NEC stage II or III and all-cause mortality. Registered Protocol: The protocol of this review was already registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42021279189.

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Section: Bmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Meta-Analysis of Enteral Lactoferrin Supplementation for Reducing the Risk of Preterm Infants Sepsis

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Tanuwijaya²

2022

SMedJour

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“…Despite the uncertainties regarding prophylactic probiotic intake, which this study aims to address, probiotics have been broadly implemented in many NICUs [42]. Probiotic alternatives, aiming to lower the risk of bacteremia, while retaining the positive eff ects on preterm infants' microbiome and infl ammatory system maturation are prebiotics and lactoferrin [43][44][45].…”

Section: Prophylaxis and Management Strategiesmentioning

confidence: 99%

Probiotic Use in Preterm Neonates: A Review and Bibliometric Analysis

Yordanov

2022

Acta Medica Bulgarica

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Background: Necrotizing enterocolitis (NEC) is a major health burden in peterm neonates with mortality rates between 21% and 50%. Prophylaxis is of primary importance as early diagnosis is hindered by the lack of specific signs and laboratory markers. Although probiotics have been routinely used for NEC prophylaxis in neonatal intensive care units around the world, clinical trials provide contradictory data, which fuels an ongoing debate about their efficacy and safety. Aims: To perform a review and bibliometric analysis on available clinical trials and case reports data on the safety and efficacy of probiotics in preterm neonates and identify relevant publication trends and patterns. Methods: A bibliometric search for publications on the topic was performed in the Web of Science Core Collection database and the resulting records analyzed in bibliometrix package in R. Results: Trends in publication activity, historical direct citation network relationships and keyword co-ocurrences were discussed in the context of the most recent therapeutic recommendations. Conclusion: We took a round view of the potential drawbacks to probiotic use in preterm infants and their possible solutions.

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Enteral Lactoferrin Supplementation for Very Preterm Infants: A Randomised Controlled Trial

Cited by 2 publications

References 18 publications

Meta-Analysis of Enteral Lactoferrin Supplementation for Reducing the Risk of Preterm Infants Sepsis

Meta-Analysis of Enteral Lactoferrin Supplementation for Reducing the Risk of Preterm Infants Sepsis

Probiotic Use in Preterm Neonates: A Review and Bibliometric Analysis

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