@misc{10481/107480,
year = {2025},
month = {10},
url = {https://hdl.handle.net/10481/107480},
abstract = {Background/Objectives: Late-onset neonatal sepsis (LOS) remains a leading cause of morbidity and mortality in very low birth weight (VLBW) infants (<1500 g and/or gestational
age <32 weeks), with limited preventive strategies. We evaluated whether early enteral
bovine lactoferrin (bLf), given its antimicrobial, immunomodulatory, and antioxidant properties, reduces LOS and improves immunologic, antioxidant, and hematologic markers
in these infants. Methods: In this randomized, double-blind, placebo-controlled trial,
103 VLBW infants received bLf (150 mg/kg/day; n = 50) or the placebo (n = 53) within
72 h of birth for four weeks or until discharge. Outcomes included culture-confirmed
LOS, mortality, and major morbidities. Risk ratios (RRs) were calculated, adjusting for
gestational age, human milk intake, and ventilatory support when ≥25 events occurred.
Pre/post changes in cytokines, total antioxidant capacity (TAC), and hemoglobin (Hb) were
analyzed for interaction effects (time x intervention). Results: bLf reduced LOS (adjusted
RR 0.54; 95% CI 0.31–0.93; p = 0.028), without differences in other morbidities or mortality. bLf preserved MCP-1 levels, declining in the placebo group (interaction p = 0.022).
Among LOS infants receiving bLf, IL-6 remained stable and MCP-1 increased, while both
declined in other groups (interaction p = 0.007 for IL-6; p = 0.052 for MCP-1). Although
TAC showed a non-significant interaction, the placebo group declined (p = 0.002), while
bLf remained stable (p = 0.400) in the post hoc analysis. In non-transfused infants, bLf
increased Hb by 0.9 g/dL vs. controls (p = 0.028). Conclusions: Early bLf supplementation
safely reduces LOS in VLBW infants and may support immunologic, antioxidant, and
hematologic stability.},
organization = {Junta de Andalucía—Consejería de Salud y Consumo (grant
number: PI-0323-2016)},
publisher = {MDPI},
keywords = {infant},
keywords = {Premature},
keywords = {sepsis},
title = {Preventing Sepsis in Preterm Infants with Bovine Lactoferrin: A Randomized Trial Exploring Immune and Antioxidant Effects},
doi = {10.3390/nu17193154},
author = {Plaza-Astasio, Virginia and Pastor Villaescusa, Belén and Rico Prados, María Cruz and Mesa García, María Dolores and Párraga-Quiles, María José and Ruiz-González, María Dolores and Jaraba-Caballero, Pilar and Tofé-Valera, Inés and De La Torre Aguilar, María José and Ordóñez Díaz, María Dolores},
}