Document Type: Original Article
Firuzabadi Medical Center, Iran University of Medical Sciences, Tehran, Iran
Mahdieh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Epidemiology Department, Tehran University of Medical Sciences, Tehran, Iran
Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
Department of Pediatrics, Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran
Background: This study was aimed to investigate the effect of enteral G-CSF on feeding tolerance in very low birth weight (VLBW) and extremely low birth weight (ELBW) neo-nates.
Methods: This historical-controlled clinical trial was conducted in Mahdieh hospital, affiliat-ed to Shahid Beheshti University of Medical Sciences, Tehran, Iran, between July 2016 and March 2017, on VLBW and ELBW neonates. In intervention group, 81 neonates with birth weights of 710-1480 were given enteral 5 μg/kg/day of G-CSF (which has been approved by the US FDA) for seven days constantly. Control group included 191 neonates with birth weights of 600-1490 admitted during 24 months prior to the study who did not receive G-CSF. Adverse effects of treatment, primary and secondary outcomes were assessed and com-pared between the groups.
Result: The mean of gestational age and birth weight in the G-CSF group were 29.96±2.47 weeks and 1204.81±201.68 grams, and in the control group were 29.77±2.13 weeks and 1189.47±207.89 grams, respectively. Neonates who received G-CSF had better feeding toler-ance, as reflected by earlier achievement of 50, 75, 100, full enteral feeding of 150, and max-imal enteral feeding of 180 mL/kg/day (p < 0.05), with earlier weight gain and a shorter hos-pital stay. The rate of necrotizing enterocolitis (NEC) in the G-CSF group was 3.7% that was significantly lower than in the control group (p=0.005). Approximately 8.9% of neonates in the control group expired which was higher than the G-CSF group (P=0.06). All neonates tol-erated the treatment and there was no statistically significant difference between the two groups.
Conclusion: Enteral administration of G-CSF in VLBW and ELBW neonates improved feeding tolerance and were well tolerated without related side effects.