Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2019, Vol. 15 ›› Issue (05): 535 -540. doi: 10.3877/cma.j.issn.1673-5250.2019.05.009

Special Issue:

Original Article

Clinical significance of oral immune therapy with colostrum on reducing incidence of nosocomial infection in very low birth weight preterm infants

Ying Yang1, Qin Zhou1, Shanyu Jiang1, Min Wang1, Yingzi Mei,1, Renqiang Yu1   

  1. 1. Department of Neonatology, the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi 214002, Jiangsu Province, China
  • Received:2019-01-03 Revised:2019-09-17 Published:2019-10-01
  • Corresponding author: Yingzi Mei
  • About author:
    Corresponding author: Mei Yingzi, Email:
  • Supported by:
    Project of Science and Research on Maternal and Child Health by Health and Family Planning Commission of Jiangsu Province(F201639); Medical Key Discipline Construction Program of Wuxi Municipal Science and Education Strengthening Health Engineering(ZDXK003); Medical Young Talent Project of Wuxi Municipal Science and Education Strengthening Health Engineering(QNRC039); Wuxi Science and Technology Development (Medical and Health) Guiding Plan Project(CSZON1723); Medical Key Research Project of Wuxi Hospital Management Center(YGZXZ1528); Maternal and Child Health Research Project of Wuxi Health and Family Planning Commission(FYKY201506, FYKY201601); Science and Technology Development Project of Nanjing Medical University(2015NJMU169)
Objective

To investigate the effect of oral immune therapy with colostrum on reducing incidence of nosocomial infection in very low birth weight (VLBW) preterm infants.

Methods

A total of 198 VLBW preterm infants who were hospitalized in neonatal intensive care unit (NICU) of the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from May 2016 to April 2018, were enrolled as research subjects. They were divided into observation group (n=108, treated by oral immune therapy with colostrum) and control group (n=98, treated by equal amount of normal saline to replacing colostrum) based on informed consent and offer colostrum or not within the first 72 h after VLBW preterm infants birth. The independent-samples t test and chi-square test were used to compare the clinical data, incidence rate of nosocomial infection and clinical outcomes between two groups of patients. This study was reviewed by the Ethics Committee of the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University (Approval No. 2018-06-0328-02). Informed consents were obtained from the guardians or entrusted agents of all infants.

Results

①There were no significant differences between two groups of VLBW preterm infants in gestational age, birth weight, proportion of small for gestational age, head circumference, constituent ratio of gender and delivery mode, incidence rate of time of premature rupture of membranes >18 h, usage of prenatal antibacterials in mother, incidence rate of asphyxia of infants, time of parenteral nutrition, proportion of twins and incidence rate of patent ductus arteriosus (P>0.05). The rate of central venous catheterization and mechanical ventilation were 38.9% and 32.4% in observation group, which were higher than those of 25.6% and 14.4% in control group, and the differences were statistically significant (χ2=3.958, P=0.047; χ2=8.625, P=0.003). ②The total incidence rate of nosocomial infection and clinical sepsis were 21.3% and 13.0% in observation group, which were lower than those of 34.4% and 25.6% in control group, and the differences were statistically significant (χ2=4.279, P=0.039; χ2=5.123, P=0.024). There were no significant differences between two groups in the incidence rates of proven sepsis, ventilator associated pneumonia (VAP) and urinary tract infection (P>0.05). ③There were no significant differences between two groups in length of hospital stay, head circumference and weight on the day of discharge, and discharge rate of improved disease conditions (P>0.05).

Conclusions

Oral immune therapy with colostrum can reduce the incidence of nosocomial infection in VLBW preterm infants.

表1 2组患儿临床资料比较
表2 2组患儿医院感染发生率比较[例数(%)]
表3 2组患儿临床结局比较
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