Neurodevelopment and Growth 2 Years After Probiotic Supplementation in Extremely Preterm Infants: A Randomised Trial

Area of Science:

• Neonatal research
• Pediatric neurodevelopment
• Microbiome research

Background:

• Extremely preterm infants face significant risks for neurodevelopmental impairments.
• Early life interventions aim to mitigate adverse outcomes in this vulnerable population.
• The role of probiotics like Limosilactobacillus reuteri in neonatal care is an area of ongoing investigation.

Purpose of the Study:

• To evaluate the effect of Limosilactobacillus reuteri supplementation on neurodevelopment and growth in extremely preterm infants.
• To assess outcomes at 2 years corrected age following early probiotic intervention.

Main Methods:

• Secondary analysis of a randomized, double-blind, placebo-controlled trial.
• Inclusion of infants born at 23-27 weeks gestation with birth weight under 1000g.
• Daily enteral supplementation with Limosilactobacillus reuteri or placebo from within 72 hours of birth until 35-36 weeks postmenstrual age.
• Neurodevelopmental assessment using Bayley-III and auxology at 24 ± 3 months corrected age.

Main Results:

• A statistically significant improvement in language scores was observed in the Limosilactobacillus reuteri group (mean 90) compared to the placebo group (mean 83; p=0.04).
• No significant differences were found in other neurodevelopmental domains or physical growth parameters between the groups.
• Follow-up data were available for 110 of 117 surviving infants, with 85 undergoing Bayley-III assessment.

Conclusions:

• Limosilactobacillus reuteri supplementation in extremely preterm infants did not alter growth or general neurodevelopmental outcomes at two years corrected age.
• A notable improvement in the language index was observed with L. reuteri supplementation.
• These findings warrant further investigation, particularly in light of previous reports of improved head circumference growth in early infancy.