Cochrane · systematic review · CD007137

Enteral lactoferrin supplementation for prevention of sepsis and necrotizing enterocolitis in preterm infants

Pammi, M, Gautham, KS · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Neonatal3 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

current version

GRADE rated

No studies

Included studies

No studies 0 · 0%Ungraded 0 · 0%Very low 6 · 42.9%Low 8 · 57.1%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

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Lactoferrin supplementation compared to control for very low birth weight infants

Population: prevention of sepsis and necrotizing enterocolitis in preterm infants

7 questions

Outcome	Effect	Evidence	Status / GRADE
All‐cause Mortality№ of participants: 5510(11 RCTs) Lactoferrin supplementation vs control	RR 0.97 [0.79, 1.2]	NR	Very low Downgraded: risk of bias, imprecision, publication bias
necrotizing enterocolitis№ of participants: 4874(7 RCTs) Lactoferrin supplementation vs control	RR 0.9 [0.69, 1.17]	NR	Low Downgraded: risk of bias, imprecision
Late onset sepsis№ of participants: 5425(12 RCTs) [Data includes both suspected and confirmed sepsis] Lactoferrin supplementation vs control	RR 0.8 [0.72, 0.89]	NR	Low Downgraded: risk of bias, imprecision
Bacterial sepsis№ of participants: 3565(8 RCTs) Lactoferrin supplementation vs control	RR 0.86 [0.74, 1]	NR	Low Downgraded: risk of bias, imprecision
Fungal infection№ of participants: 3266(6 RCTs) Lactoferrin supplementation vs control	RR 0.23 [0.1, 0.54]	NR	Low Downgraded: risk of bias, imprecision
Chronic lung disease№ of participants: 2984(5 RCTs) Lactoferrin supplementation vs control	RR 1 [0.89, 1.12]	NR	Low Downgraded: risk of bias, imprecision
Length of hospital stay№ of participants: 1079(3 RCTs) Lactoferrin supplementation vs control	no estimate extracted	NR	Very low Downgraded: risk of bias, imprecision, publication bias

Lactoferrin supplementation with enteral feeds in combination with probiotics compared to placebo for prevention of sepsis and necrotizing enterocolitis in preterm infants

Population: prevention of sepsis and necrotizing enterocolitis in preterm infants

7 questions

Outcome	Effect	Evidence	Status / GRADE
Any late‐onset sepsis ‐ All infants [Data on only confirmed sepsis available] Lactoferrin supplementation with enteral feeds in combination with probiotics vs placebo	RR 0.25 [0.14, 0.46]	3 studies · 564 participants	Low Downgraded: risk of bias, imprecision
NEC ≥ stage II Lactoferrin supplementation with enteral feeds in combination with probiotics vs placebo	RR 0.04 [0, 0.62]	1 study · 496 participants	Very low Downgraded: risk of bias, imprecision
All‐cause mortality Lactoferrin supplementation with enteral feeds in combination with probiotics vs placebo	RR 0.58 [0.3, 1.13]	2 studies · 671 participants	Very low Downgraded: risk of bias, imprecision
Bacterial sepsis Lactoferrin supplementation with enteral feeds in combination with probiotics vs placebo	RR 0.28 [0.11, 0.72]	1 study · 319 participants	Low Downgraded: risk of bias, imprecision
Fungal Infection Lactoferrin supplementation with enteral feeds in combination with probiotics vs placebo	RR 0.24 [0.08, 0.71]	2 studies · 494 participants	Low Downgraded: risk of bias, imprecision
Chronic lung disease Lactoferrin supplementation with enteral feeds in combination with probiotics vs placebo	RR 0.67 [0.25, 1.79]	1 study · 319 participants	Very low Downgraded: risk of bias, imprecision
Length of stay among survivors Lactoferrin supplementation with enteral feeds in combination with probiotics vs placebo	no estimate extracted	1 study · 496 participants	Very low Downgraded: risk of bias, imprecision