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Prebiotic supplementation in preterm neonates: updated systematic review and meta-analysis of randomised controlled

Ravisha Srinivasjois1, Shripada Rao, Sanjay Patole

  • 1Department of Neonatology and Paediatrics, Joondalup Health Campus and Joondalup Child Development Centre, Joondalup, Western Australia, Australia; Department of Neonatology, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.

Clinical Nutrition (Edinburgh, Scotland)
|June 22, 2013
PubMed

Insights

Prebiotic oligosaccharide supplementation in preterm infants is safe. It did not reduce necrotizing enterocolitis or sepsis but significantly increased beneficial gut bacteria growth.

Area of Science:

  • Neonatal Nutrition
  • Gut Microbiome Research
  • Clinical Pediatrics

Background:

  • Prebiotic oligosaccharides promote beneficial gut flora in infants.
  • Preterm infants have altered gut microbiota composition.
  • Investigating prebiotic supplementation in preterm infants is crucial for optimizing gut health.

Purpose of the Study:

  • To systematically review randomized controlled trials on prebiotic oligosaccharide supplementation in preterm infants (≤ 37 weeks gestation).
  • To evaluate the safety and efficacy of these supplements.
  • To assess impact on gut microbiota, clinical outcomes, and growth.

Main Methods:

  • Systematic review of randomized controlled trials from Medline and Embase.
  • Included studies compared formula milk with or without prebiotics.
  • Outcomes assessed included necrotizing enterocolitis (NEC), sepsis, feed tolerance, growth, and stool characteristics.

Main Results:

  • Seven trials (n=417) were included. No significant reduction in NEC (RR 1.24) or late-onset sepsis (RR 0.81) was observed.
  • Prebiotic supplementation did not improve time to full enteral feeds.
  • A significant increase in bifidobacteria growth (WMD 0.53) and reduced stool viscosity/pH were noted. No life-threatening adverse effects were reported.

Conclusions:

  • Prebiotic oligosaccharide supplementation is safe for preterm infants.
  • It does not decrease the incidence of NEC, late-onset sepsis, or time to full enteral feeds.
  • Supplementation significantly enhances the growth of beneficial gut microbes.
Abstract

Keywords:
BifidobacteriaEnteral feedsLactobacillusNecrotising enterocolitisPrebiotic oligosaccharidesSepsis

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