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Prebiotic supplementation of formula in preterm neonates: a systematic review and meta-analysis of randomised

Ravisha Srinivasjois1, Shripada Rao, Sanjay Patole

  • 1Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia.

Clinical Nutrition (Edinburgh, Scotland)
|April 11, 2009
PubMed

Insights

Prebiotic oligosaccharide supplementation in preterm infant formula increased beneficial gut bacteria like bifidobacteria. This intervention did not negatively impact infant weight gain.

Area of Science:

  • Neonatal nutrition
  • Microbiome research
  • Gastroenterology

Background:

  • Preterm neonates are at high risk for necrotizing enterocolitis (NEC) and sepsis.
  • Gut microbiome alterations are implicated in NEC pathogenesis.
  • Prebiotic supplementation may modulate the gut microbiota and improve outcomes.

Purpose of the Study:

  • To evaluate the efficacy and safety of prebiotic oligosaccharide-supplemented formula in preterm infants.
  • To assess the impact on NEC and sepsis incidence.
  • To examine effects on growth, gut colonization, and stool characteristics.

Main Methods:

  • Systematic review of randomized controlled trials.
  • Searched multiple databases including Cochrane, MEDLINE, EMBASE, and CINAHL.
  • Included trials with prebiotic-supplemented vs. unsupplemented formula in neonates ≤37 weeks gestation, initiated within 28 days of life and lasting ≥2 weeks.

Main Results:

  • One study reported no NEC cases in the prebiotic group; others did not report NEC or sepsis data.
  • Meta-analysis showed no significant difference in weight gain between groups.
  • Prebiotic supplementation significantly increased Bifidobacterial counts in stool (WMD=0.53; 95% CI: 0.33, 0.73) logCFU/g.

Conclusions:

  • Prebiotic-supplemented formula enhances stool Bifidobacteria and Lactobacilli counts in preterm neonates.
  • This supplementation appears safe regarding weight gain.
  • Further research is needed to confirm effects on NEC and sepsis incidence.
Abstract

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