Effects of prophylactic probiotics supplementation on infants born very preterm or very low birth weight

Area of Science:

• Neonatal Medicine
• Microbiome Research
• Clinical Pediatrics

Background:

• Infants born very preterm (VP) or very low birth weight (VLBW) are at high risk for serious complications.
• Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality in this vulnerable population.
• Probiotics are explored for their potential to modulate the gut microbiome and prevent neonatal diseases.

Purpose of the Study:

• To assess the impact of guideline-driven, multi-strain probiotic supplementation on VP/VLBW infants.
• To evaluate the effect of probiotics on the incidence of necrotizing enterocolitis (NEC).
• To determine if probiotic use influences other key neonatal outcomes such as mortality and late-onset sepsis.

Main Methods:

• A prospective cohort study compared 125 VP/VLBW infants receiving probiotics to 126 retrospective controls not receiving probiotics.
• The primary outcome measured was the incidence of necrotizing enterocolitis (NEC).
• Secondary outcomes included mortality and late-onset sepsis, with adjustments for relevant variables.

Main Results:

• The incidence of NEC decreased from 6.3% to 1.6% in the probiotic group.
• After multivariable adjustment, the reduction in NEC was not statistically significant (OR 0.27; 95% CI 0.05-1.33).
• No significant differences were found for mortality (OR 0.76; 95% CI 0.26-2.21) or late-onset sepsis (OR 0.54; 95% CI 0.18-1.63); no adverse effects were reported.

Conclusions:

• Prophylactic probiotic supplementation in VP/VLBW infants showed a trend towards reducing NEC incidence.
• The observed reduction in NEC did not reach statistical significance in this study.
• Further research may be warranted to confirm the potential benefits of probiotics in this high-risk neonatal population.