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
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
14
current version
GRADE rated
14
No studies
0
Included studies
NR
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
Current version onlyLactoferrin supplementation compared to control for very low birth weight infants
Population: prevention of sepsis and necrotizing enterocolitis in preterm infants
| 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
| 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 |
Oral lactoferrin compared with placebo for prevention of sepsis and necrotizing enterocolitis in preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any late‐onset sepsis ‐ all infants Oral lactoferrin vs placebo | RR 0.59 [0.4, 0.87] | 6 studies · 886 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Bacterial sepsis Oral lactoferrin vs placebo | RR 0.46 [0.29, 0.74] | 4 studies · 760 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality Oral lactoferrin vs placebo | RR 0.65 [0.37, 1.11] | 6 studies · 1041 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
NEC ≥ stage II Oral lactoferrin vs placebo | RR 0.4 [0.18, 0.86] | 4 studies · 750 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Chronic lung disease Oral lactoferrin vs placebo | RR 0.86 [0.52, 1.42] | 3 studies · 520 participants | Low Downgraded: risk of bias, imprecision |
Threshold retinopathy of prematurity Oral lactoferrin vs placebo | RR 0.5 [0.27, 0.97] | 2 studies · 400 participants | Low |
Length of stay among survivors Oral lactoferrin vs placebo | no estimate extracted | 1 study · 505 participants | Low Downgraded: imprecision |
Oral lactoferrin + probiotics compared with placebo for prevention of sepsis and necrotizing enterocolitis in preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any late‐onset sepsis ‐ all infants Oral lactoferrin + probiotics vs placebo | RR 0.27 [0.12, 0.6] | 1 study · 319 participants | Low Downgraded: risk of bias, imprecision |
Bacterial sepsis Oral lactoferrin + probiotics vs placebo | RR 0.28 [0.11, 0.72] | 1 study · 319 participants | Moderate Downgraded: risk of bias, imprecision |
All‐cause mortality Oral lactoferrin + probiotics vs placebo | RR 0.54 [0.25, 1.18] | 1 study · 496 participants | Low Downgraded: risk of bias, imprecision |
NEC ≥ stage II Oral lactoferrin + probiotics vs placebo | RR 0.04 [0, 0.62] | 1 study · 496 participants | Low Downgraded: risk of bias, imprecision |
Chronic lung disease Oral lactoferrin + probiotics vs placebo | RR 0.67 [0.25, 1.79] | 1 study · 319 participants | Low Downgraded: risk of bias, imprecision |
Threshold retinopathy of prematurity Oral lactoferrin + probiotics vs placebo | RR 0.76 [0.39, 1.49] | 1 study · 319 participants | Low Downgraded: risk of bias, imprecision |
Length of stay among survivors Oral lactoferrin + probiotics vs placebo | no estimate extracted | 1 study · 496 participants | Low Downgraded: risk of bias, imprecision |
Oral lactoferrin compared with placebo for prevention of sepsis and necrotizing enterocolitis in preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any late‐onset sepsis ‐ all infants Oral lactoferrin vs placebo | RR 0.49 [0.32, 0.73] | 4 studies · 678 participants | Moderate Downgraded: risk of bias |
Fungal sepsis Oral lactoferrin vs placebo | RR 0.08 [0.01, 0.64] | 1 study · 321 participants | Low Downgraded: imprecision |
All‐cause mortality Oral lactoferrin vs placebo | RR 0.3 [0.12, 0.75] | 2 studies · 552 participants | Low Downgraded: risk of bias |
NEC ≥ stage II Oral lactoferrin vs placebo | RR 0.3 [0.12, 0.76] | 2 studies · 552 participants | Low |
Chronic lung disease Oral lactoferrin vs placebo | RR 0.71 [0.34, 1.48] | 2 studies · 441 participants | Low |
Threshold retinopathy of prematurity Oral lactoferrin vs placebo | RR 0.35 [0.14, 0.85] | 1 study · 321 participants | Low Downgraded: imprecision |
Length of stay among survivors Oral lactoferrin vs placebo | no estimate extracted | 1 study · 505 participants | Low Downgraded: imprecision |
Oral lactoferrin + probiotics compared with placebo for prevention of sepsis and necrotizing enterocolitis in preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any late‐onset sepsis ‐ all infants Oral lactoferrin + probiotics vs placebo | RR 0.27 [0.12, 0.6] | 1 study · 319 participants | Low Downgraded: risk of bias, imprecision |
Fungal sepsis Oral lactoferrin + probiotics vs placebo | RR 0.26 [0.07, 0.88] | 1 study · 319 participants | Moderate Downgraded: risk of bias |
All‐cause mortality Oral lactoferrin + probiotics vs placebo | RR 0.54 [0.25, 1.18] | 1 study · 496 participants | Low Downgraded: risk of bias, imprecision |
NEC ≥ stage II Oral lactoferrin + probiotics vs placebo | RR 0.04 [0, 0.62] | 1 study · 496 participants | Low Downgraded: risk of bias, imprecision |
Chronic lung disease Oral lactoferrin + probiotics vs placebo | RR 0.74 [0.21, 2.58] | 1 study · 319 participants | Low Downgraded: risk of bias, imprecision |
Threshold retinopathy of prematurity Oral lactoferrin + probiotics vs placebo | RR 0.76 [0.39, 1.49] | 1 study · 319 participants | Low Downgraded: risk of bias, imprecision |
Length of stay among survivors Oral lactoferrin + probiotics vs placebo | no estimate extracted | 1 study · 496 participants | Low Downgraded: risk of bias, imprecision |