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Neonatal outcomes following introduction of routine probiotic supplementation to very preterm infants

David B Healy1,2,3, Benjamin Campbell-Green2, Vicki Livingstone2,3

  • 1APC Microbiome Ireland, UCC, Cork, Ireland.

Acta Paediatrica (Oslo, Norway : 1992)
|July 28, 2023
PubMed

Insights

Routine probiotic supplementation with Bifidobacterium bifidum and Lactobacillus acidophilus significantly reduced the combined outcome of severe necrotising enterocolitis (NEC) and/or death in very preterm infants. This finding supports the use of probiotics in neonatal intensive care.

Area of Science:

  • Neonatal Medicine
  • Microbiology
  • Gastroenterology

Background:

  • Necrotising enterocolitis (NEC) and death are significant concerns for very preterm infants.
  • Probiotic supplementation is explored as a strategy to improve neonatal outcomes.
  • Bifidobacterium bifidum and Lactobacillus acidophilus are commonly used probiotic strains.

Purpose of the Study:

  • To assess the impact of routine probiotic supplementation (Bifidobacterium bifidum and Lactobacillus acidophilus) on the combined outcome of death and/or severe NEC.
  • To compare outcomes in very preterm infants before and after the introduction of probiotics at Cork University Maternity Hospital.

Main Methods:

  • Retrospective study of infants <32 weeks gestation and <1500g surviving beyond 72 hours.
  • Two 6-year epochs were analyzed: pre-probiotic (2008-2013) and with probiotic (2015-2020).
  • Primary outcome: death after 72 hours or NEC Bell stage 2a or greater.

Main Results:

  • 744 infants were included (391 in Epoch 1, 353 in Epoch 2).
  • The primary outcome occurred in 67 infants (37 in Epoch 1, 30 in Epoch 2).
  • After adjustment, probiotic use was associated with a significant reduction in the composite outcome (OR: 0.53 [0.29 to 0.97], p=0.038).

Conclusions:

  • Routine administration of Bifidobacterium bifidum and Lactobacillus acidophilus probiotics was associated with a reduction in severe NEC and/or death.
  • The findings suggest a protective effect of these probiotics in very preterm infants.
  • Adjusted analysis indicated a significant benefit, independent of gestational age group.
Abstract

Keywords:
necrotising enterocolitisprobioticsvery premature neonates

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