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Outcomes in preterm small versus appropriate for gestation infants after Bifidobacterium breve M-16 V supplementation

Gayatri Athalye-Jape1,2, Novia Minaee3, Elizabeth Nathan3

  • 1Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, Australia.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|November 6, 2018
PubMed

Insights

Routine probiotic supplementation with Bifidobacterium breve M-16V showed similar rates of necrotizing enterocolitis, late-onset sepsis, and mortality in preterm small for gestational age (SGA) versus appropriate for gestational age (AGA) infants. However, SGA infants required more time to reach full feeds.

Area of Science:

  • Neonatal Medicine
  • Microbiome Research
  • Pediatric Gastroenterology

Background:

  • Preterm infants, particularly those small for gestational age (SGA), face increased risks of feeding intolerance and adverse outcomes.
  • Routine probiotic supplementation (RPS) with Bifidobacterium breve M-16V is used in neonatal intensive care units.
  • Previous studies indicated comparable fecal bifidobacteria responses to B. breve M-16V in preterm SGA and appropriate for gestational age (AGA) infants.

Purpose of the Study:

  • To compare clinical outcomes, including necrotizing enterocolitis (NEC), sepsis, and mortality, between preterm SGA and AGA infants receiving RPS with B. breve M-16V.
  • To assess the impact of RPS on time to full enteral feeds in these infant groups.

Main Methods:

  • Retrospective cohort study analyzing data from June 2012 to August 2015.
  • Inclusion of preterm infants (<34 weeks gestation), with a subgroup analysis for infants <29 weeks gestation.
  • Comparison of outcomes between SGA and AGA infants using multivariable regression, focusing on NEC (≥Stage II), all-cause mortality, late-onset sepsis (LOS), and postnatal age at full feeds (PAFF).

Main Results:

  • While the primary outcome (NEC ≥ Stage II/all-cause mortality) was higher in SGA versus AGA infants <29 weeks (21% vs. 12%), rates of NEC (≥Stage II), LOS, and all-cause mortality were comparable between SGA and AGA infants across both <34 weeks and <29 weeks gestation groups.
  • Median postnatal age at full feeds (PAFF) was significantly longer for SGA infants compared to AGA infants in both <34 weeks (8 vs. 7 days) and <29 weeks (14 vs. 11 days) groups.
  • A trend toward reduction in the primary outcome was observed in AGA infants <34 weeks (8% vs. 6%).

Conclusions:

  • Routine probiotic supplementation with Bifidobacterium breve M-16V did not significantly alter rates of NEC, LOS, or all-cause mortality in preterm SGA versus AGA infants.
  • Preterm SGA infants supplemented with B. breve M-16V experienced a significantly longer duration to achieve full enteral feeds compared to their AGA counterparts.
  • These findings highlight the need for tailored feeding strategies for preterm SGA infants even with probiotic use.

Keywords:
Bifidobacterium breve M-16 Vpretermprobioticsmall for gestation age

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