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Benefits of routine probiotic supplementation in preterm infants

C P Rath1,2, G Athalye-Jape1,2, E Nathan3,4

  • 1Neonatology Directorate, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia.

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

Insights

Routine probiotic supplementation (RPS) for preterm infants continues to show sustained benefits. This study found that RPS significantly reduced necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in recent years.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Microbiome Research

Background:

  • Routine probiotic supplementation (RPS) was introduced for preterm infants in 2012.
  • Previous studies demonstrated that RPS reduced necrotizing enterocolitis (NEC) and mortality.
  • The current study aimed to assess the sustained benefits of RPS in the contemporary clinical setting.

Purpose of the Study:

  • To evaluate if the benefits of routine probiotic supplementation (RPS) in preterm infants have been maintained over time.
  • To compare outcomes of preterm infants across three epochs: pre-RPS, early RPS, and current RPS era.

Main Methods:

  • A comparative study design was employed, analyzing data from three distinct epochs.
  • Epoch 1: No RPS (December 2008 - November 2010).
  • Epochs 2 & 3: With RPS (June 2012 - May 2014 and June 2014 - December 2019, respectively).
  • Statistical analysis included multiple logistic and Cox regression models to compare infant outcomes.

Main Results:

  • A total of 3072 preterm infants were analyzed across the three epochs.
  • Infants in epoch 3 (<28 weeks gestation) showed significantly lower rates of NEC and late-onset sepsis (LOS) compared to epoch 1.
  • Epoch 3 infants (<28 weeks and 28-32 weeks gestation) reached full feeds significantly earlier compared to epochs 1 and 2.
  • LOS and age at full feeds were significantly lower in epoch 3 compared to epoch 2 for infants 28-32 weeks gestation.

Conclusions:

  • The positive outcomes associated with routine probiotic supplementation (RPS) in preterm infants are sustained in the current era.
  • RPS remains an effective intervention for reducing NEC and LOS, and improving feeding tolerance in vulnerable preterm populations.
Abstract

Keywords:
necrotising enterocolitispreterm infantsprobioticssupplementationvery low birth weight

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