Imunoterapia orofaríngea de colostro e ganho ponderal em recém-nascidos prematuros de muito baixo peso

Abstract

Oropharyngeal Colostrum Immunotherapy (IOC) assists in the initiation and progression of nutritional therapy by promoting intestinal growth and maturation, reducing food intolerance events and improving the clinical evolution of premature newborns. However, the result of this immunotherapy on weight gain in neonates has been little explored. For this reason, the present study evaluated the effect of oropharyngeal colostrum immunotherapy on the growth velocity of very low birth weight premature newborns admitted to a public maternal and child care unit. This is a non-randomized clinical trial with historical control. Premature newborns born weighing less than 1500g were allocated into two groups according to the period of their admission to the neonatal intensive care unit: in the control group, those admitted between 2015 and 2018, and in the intervention group, those admitted after the implantation of a IOC protocol, between 2019 and 2020. The treatment regimen consisted daily of 8 administrations of 0.2 ml (four drops) of colostrum for 10 seconds in the oropharyngeal mucosa, offered every 03 hours, until the seventh day of life of the child. Newborns were weighed naked, once a day, by the team of professionals from the sectors involved, previously trained by the research group, until hospital discharge or death. Data collection for the historical control group was carried out retrospectively through medical records. To assess the effect of the IOC on the weight gain of premature children, Generalized Estimation Equation (GEE) modeling was performed. In the neonatal period, growth deceleration was identified in the first 7 days of life in both groups, followed by a greater increase in weight gain between 21 and 28 days in the IOC group (Pre-IOC: mean: 11.79; SD: 10.24 ; IOC: mean: 16.29; SD: 11.72; p=0.05). In the multivariate analysis, after adjusting for confounding factors, IOC increased the rate of weight gain by 1.99 g/kg/day (p<0.01) and z-score for age by 0.33 (p<0 ,01). Data from the present study suggest that IOC favored weight gain in very low birth weight premature newborns in the neonatal period.