Department of Physiology, University of Granada, Granada, Spain.
Institute of Nutrition and Food Technology "José Mataix Verdú", University of Granada, Granada, Spain.
Pediatr Allergy Immunol. 2019 Mar;30(2):234-241. doi: 10.1111/pai.13008. Epub 2018 Dec 13.
The immune system of preterm infants is immature, being a significant cause of morbidity and mortality, particularly in the preterm infant. Oropharyngeal colostrum administration could be an immunomodulatory aid. Our aim was to evaluate the effect of oropharyngeal colostrum on the serum levels of immunoglobulins, lactoferrin, and resistin during the first month of life and to track the clinical outcome of the neonates.
One hundred preterm neonates born at <32 weeks of gestation and/or weighing < 1500 g and assisted in the Neonatal Intensive Care Unit were enrolled and divided into two groups: colostrum (n = 48) and control (n = 52). The subjects assigned to the colostrum group received 0.2 mL of colostrum (oropharyngeal route) every 4 hours for the first 15 days of life, and if mothers have inability to breastfeed, they were included in the control group (no oropharyngeal colostrum). Serum concentrations of IgA, IgM, and IgG1, lactoferrin, and resistin were assessed in both groups at 1, 3, 15, and 30 days of life. Clinical data during hospitalization were collected.
IgA and IgM increased in preterm neonates who were administered colostrum for 15 and 30 days. Lactoferrin increased after 30 days, and resistin increased after 15 days of supplying oropharyngeal colostrum. The colostrum group underwent full enteral nutrition before, and no differences were observed in the common neonatal morbidities.
Oropharyngeal colostrum administration is safe in preterm neonates and improves their immunologic profile, showing a potential role as an immunomodulatory agent.
早产儿的免疫系统不成熟，这是发病率和死亡率的重要原因，尤其是在早产儿中。口咽喂养初乳可能是一种免疫调节辅助手段。我们的目的是评估口咽初乳在生命的第一个月对免疫球蛋白、乳铁蛋白和抵抗素血清水平的影响，并跟踪新生儿的临床结果。
我们招募了 100 名胎龄<32 周和/或体重<1500g 的早产儿，并将他们分为两组：初乳组（n=48）和对照组（n=52）。初乳组的受试者在生命的前 15 天内每 4 小时接受 0.2 毫升初乳（口咽途径），如果母亲不能母乳喂养，则将其纳入对照组（无口咽初乳）。在第 1、3、15 和 30 天，评估两组血清中 IgA、IgM 和 IgG1、乳铁蛋白和抵抗素的浓度。收集住院期间的临床数据。
接受口咽初乳 15 和 30 天的早产儿 IgA 和 IgM 增加。乳铁蛋白在 30 天后增加，抵抗素在口咽初乳供应 15 天后增加。初乳组在进行完全肠内营养之前，常见的新生儿并发症没有差异。
口咽初乳在早产儿中是安全的，可改善其免疫状态，显示出作为免疫调节剂的潜在作用。
