Effect of Enteral Administration of Granulocyte-Colony Stimulating Factor (G-CSF) on Feeding Tolerance in Very Low Birth Weight and Extremely Low Birth Weight Neonates; a Historical-Controlled Clinical Trial

Document Type: Original Article

Authors

1 Firuzabadi Medical Center, Iran University of Medical Sciences, Tehran, Iran

2 Mahdieh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Epidemiology Department, Tehran University of Medical Sciences, Tehran, Iran

4 Endometriosis Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran

5 Department of Pediatrics, Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran

Abstract

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.

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