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Early Versus Late Lactoferrin in Prevention of Neonatal Sepsis

Phase 4
Completed
Conditions
Neonatal Sepsis
Interventions
Drug: Placebo (for Lactoferrin)
Registration Number
NCT02959229
Lead Sponsor
Ain Shams University
Brief Summary

The present study was designed to evaluate the effectiveness of oral lactoferrin in prevention of neonatal sepsis with comparison early (1st day) versus late (48-72 hours) Lactoferrin administration, Secondary aim was to study effect of Lactoferrin administration on serum Ferritin and follow up long term outcome (Bronchopulmonary dysplasia, retinopathy of prematurity and necrotizing enterocolitis.

Detailed Description

This study was carried out on 180 preterm neonates(\< 37 weeks of gestation counting from the first day of the Last Menstrual Period and confirmed by Ballard score) admitted to the Neonatal Intensive Care Units of Ain Shams University Hospitals in the period from August 2014 to December 2015.

Enrolled subjects were further randomly subdivided into three groups according to the dose regimen of Lactoferrin supplementation.

* Group A: (60 preterm neonates) who received oral Lactoferrin supplementation in a dose of 100 mg/day starting on day 1 and continue for 4-6 weeks.

* Group B: (60 preterm neonates) who received oral Lactoferrin supplementation in a dose of 100 mg/day starting on day 3 (48hrs-72hrs) of life and continue for 4-6 weeks.

* Group C: (60 preterm neonates) who match the subjected neonates, received placebo in form of distilled water.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
180
Inclusion Criteria
  1. Neonates with a < 37 weeks of gestation counting from the first day of the Last Menstrual Period.
  2. Preterm neonates are breast fed, artificially fed or on total parenteral nutrition.
  3. Preterm neonates born in, or referred to our Neonatal Intensive Care Unit in the first day of life free from infection and not fed.
Exclusion Criteria
  1. Neonates with underlying gastrointestinal problems that prevent oral intake.
  2. Neonates with predisposing conditions that profoundly affect growth and development (chromosomal abnormalities, structural brain anomalies, severe congenital abnormalities).
  3. Neonates with a family background of cow milk allergy.
  4. Neonates who will not have the chance to complete the study time (who will be referred to another hospitals).
  5. Neonates with early onset sepsis.
  6. Neonates whose parents decline to participate.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo GroupPlacebo (for Lactoferrin)placebo in form of distilled water once starting on day 1 of life and continued for 4-6 weeks.
Late Lactoferrin GroupLactoferrinOral Bovine Lactoferrin 100 mg/day once starting on day 3 of life and continued for 4-6 weeks.
Early Lactoferrin GroupLactoferrinOral Bovine Lactoferrin 100 mg/day once starting on day 1 of life and continued for 4-6 weeks.
Primary Outcome Measures
NameTimeMethod
Evaluate the effectiveness of oral Lactoferrin in prevention of neonatal sepsis according to Tollner score, hematological scoring system (HSS) and positive blood culture.4-6 weeks of life
Compare early (1st day) versus late (48-72 hours) Lactoferrin administration on neonatal sepsis according to Tollner score, hematological scoring system (HSS) and positive blood culture4-6 weeks of life
Secondary Outcome Measures
NameTimeMethod
Effect of Lactoferrin supplementation on long term complications4-6 weeks of life

Long term complications as:

Broncho-Pulmonary Dysplasia using clinical symptoms and signs and chest X ray findings.

Retinopathy of Prematurity using the International Classification of Retinopathy of Prematurity (ICROP).

Necrotizing Enterocolitis using Modified Bell's criteria for staging Necrotizing Enterocolitis.

any reported side effects for Bovine Lactoferrin4-6 weeks of life
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