The Optimal Time for Initiating Probiotics for Preterm and Very-Low-Birth-Weight Infants: A 10-Year Experience in a...

Area of Science:

• Neonatal Medicine
• Microbiome Research
• Pediatric Nutrition

Background:

• Probiotic supplementation timing in preterm infants is variable.
• Optimal initiation strategies for probiotics in premature infants are not well-defined.
• Early life microbial colonization is critical for infant development.

Purpose of the Study:

• To determine the optimal timing for initiating probiotic supplementation in preterm or very low birth weight (VLBW) infants.
• To investigate the association between early probiotic introduction and adverse neonatal outcomes.
• To compare clinical outcomes between early and late probiotic administration.

Main Methods:

• Retrospective review of medical records for preterm infants (<32 weeks GA) or VLBW infants (2011-2020).
• Categorization into early introduction (EI) group (probiotics within 7 days) and late introduction (LI) group (probiotics after 7 days).
• Statistical analysis of clinical characteristics and outcomes between EI and LI groups, including multivariate analysis.

Main Results:

• A total of 370 infants were analyzed. The LI group had significantly lower gestational age and birth weight compared to the EI group.
• Late probiotic introduction was independently associated with increased risks of late-onset sepsis (OR, 2.85), delayed full enteral nutrition (OR, 5.44), and extrauterine growth restriction (OR, 1.67).
• Gestational age at birth and enteral nutrition start day were significant factors influencing late probiotic initiation.

Conclusions:

• Early probiotic supplementation within the first week of life may be beneficial for preterm and VLBW infants.
• Timely probiotic administration could mitigate risks of serious adverse neonatal outcomes.
• Further research may confirm the benefits of early probiotic use in vulnerable infant populations.