Colostroterapia como ferramenta terapêutica para recém-nascidos prematuros internados em unidades de terapia intensiva: uma revisão sistemática

Abstract

Observing the world scenario related to neonatal morbidity and mortality, much research has been done on the use of new therapeutic tools that aim to strengthen and promote the health of newborns, especially premature infants. Therefore, Colostrum Therapy has emerged as a possible therapeutic tool option, requiring further investigation and deepening of this subject. Thus, the main objective of this study is to analyze the analyze the effects of colostrum oropharyngeal administration in preterm and low birth weight newborns. This is a Systematic Review, based on the search in the Virtual Health Library database, which includes MEDLINE, LILACS, and BDENF, and also SciELO, COCHRANE LIBRARY, and PUBMED. The controlled descriptors "Colostrum", "Colostrum", "First Milk", "Secretory Immunoglobulin A", and "Maternal-Acquired Immunity" were used. Inclusion criteria are clinical trials that characterize the use of human colostrum as therapy for preterm and low birth weight newborns who are admitted to intensive care units, in English or Portuguese, published in the last 10 years, available in full free of charge, and meeting the scope of this review. The reading was paired and the collection took place using an instrument that contemplated the review's objective. The 7 articles analyzed at the end of the search process had their risks of bias evaluated using the RoB 2.0 tool. As beneficial effects were found in the treatment group: increased levels of Secretory Immunoglobulin A, reduced time to complete enteral feeding, reduced length of hospital stay, reduced incidence of late onset sepsis, increased peptides corresponding to lactoferrin, immunoglobulin A, and lysozyme C and reductions in S100A7 and alpha defensin 5, lower percentage of Moraxellaceae and lower percentage of Staphylococcaceae in the oral mucosa, reduced incidence of necrotizing enterocolitis and IVH,

lower levels of proinflammatory cytokines (IL-6, IL-8), and higher expression of anti- inflammatory cytokines (IL -10 and IL-1ra). Although no statistically significant differences were found in all the variables studied, the results point to a beneficial trend of Colostrum Therapy in premature newborns.