Role of probiotics in clinical course and outcome of preterm neonates
DOI:
https://doi.org/10.18203/2349-3291.ijcp20211676Keywords:
Probiotics, Preterm neonates, NEC, SepsisAbstract
Background: In a quest to improve the outcome of preterm neonates and to reduce neonatal mortality a lot of research has been done in the field of neonatology; one such intervention is the use of probiotics. We evaluated the role of probiotics in reducing the incidence and severity of NEC, sepsis, hyperbilirubinemia and in improving enteral feeds in preterms.
Methods: A prospective randomized control trial was conducted in preterm neonates <37 weeks of gestation from December 2017 to November 2019. They were randomized into test and control groups. The neonates in the test group were fed with probiotics with breast milk twice daily till they reach full feeds. Babies in the control group were fed with breast milk alone. Various parameters were compared between two groups like incidence of NEC, sepsis etc.
Results: Sixty preterm neonates were enrolled, 30 in the test group and 30 in the control group. The demographic and clinical variables were similar in both groups. The incidence of NEC and sepsis in the test group is less compared to the control group. Duration of phototherapy was less in test group (1.10.3 days) compared to control group (1.90.9 days). Duration of hospital stay in test group was less (8.92.1 days) compared to the control group (11.43.7 days).
Conclusions: Prophylactic probiotics have a beneficial role in prevention of NEC and sepsis, reducing duration of phototherapy and duration of hospital stay in preterm neonates.
References
Sharma AA, Jen R, Butler A, Lavoie PM. The developing human preterm neonatal immune system: a case for more research in this area. Clin Immunol. 2012;145:61-8.
Blencowe H, Cousens S, Oestergaard M, Chou D, Moller AB, Narwal R, Adler A, Garcia CV, Rohde S, Say L, Lawn JE. National, regional and worldwide estimates of preterm birth. The Lancet. 2012;379(9832):2162-72.
Data Warehouse – UNICEF DATA. https://data.unicef.org/resources/data_explorer/unicef_f/?ag=UNICEF&df=GLOBAL_DATAFLOW&ver=1.0&dq=IND.CME_MRM0.&startPeriod=1970&endPeriod=2021. Last accessed on 12th November, 2020.
Cloherty JP, Eichenwald EC, Stark AR. Manual of neonatal care. 6th ed. Philadelphia: Lippincott Williams and Wilkins. 2008;608-15.
Stoll BJ. The global impact of neonatal infection. Clin Perinatol. 1997;24:1-21.
Uberos J, Aguilera-Rodríguez E, Jerez-Calero A. Probiotics toprevent necrotizing enterocolitis and nosocomial infection in very low birth weight preterm infants. Br J Nutr. 2017;117(7):994-1000.
Manzoni P, Mostert H, Leonessa ML. Oral supplementation with Lactobacillus casei subspecies rhamnosus prevents enteric colonization by Candida species in preterm neonates: a randomized study. Clinical Infectious Diseases. 2006;42(12):1735-42.
Arora S, Khurana MS. To study the role of probiotics in the prevention of necrotizing enterocolitis in preterm neonates. Int J Contemp Pediatr. 2017;4(5):1792-7.
Torkaman M, Mottaghizadeh F. The Effect of Probiotics on Reducing Hospitalization Duration in Infants With Hyperbilirubinemia Iran J Pediatr. 2016;27(1):e5096.
Demirel G, Celik IH, Erdeve O, Dilmen U. Impact of probiotics on the course of indirect hyperbilirubinemia and phototherapy duration in very low birth weight infants. J Matern Fetal Neonatal Med. 2017;26:215-8.
Liu W, Liu H, Wang T, Tang X. Therapeutic effects of probiotics on neonatal jaundice. Pak J Med Sci. 2015;31:1172-1175.
Chandrasekhar J, Varghese TP, Gopi A, Raj M, Sudevan R. Treatment Effect of Probiotic Bacillus Clausii on Neonatal Jaundice in Late Preterm and Term Newborn Babies: An Experimental Study. Pediatr Ther. 2017;7:326.
Bin-Nun A, Bromiker R, Wilschanski M, Kaplan M, Rudensky B, Caplan M, Hammerman C. Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates. J Pediatr. 2005;147:192-6.
Hoyos AB. Reduced incidence of Necrotizing enterocolitis associated with enteral administration of Lactobacillus acidophilus and Bifidobacterium infants to neonates in an intensive care unit. Int J infection Dis. 1999;3:197-202.
Dani C, Baidaioli R, Bertini G, Martelli E, Rubaltelli FF. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm neonates. A prospective double blind study. 2002;82:103-8.
Costalos C, Skouteni V, Gounavis AD et al. External feeding of premature infants with Saccharomyces boluardil. Early Human Development. 2003;74:89-96.
Lin CH, Su BH, Chen AC. Oral Probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight neonates. Pediatrics. 2005;115:1-4.
Lin HC, Hus CH, Chen HL. Oral probiotics prevent Necrotizing Enterocolitis in very low Birth weight preterm infants: A multicenter. Randomized Controlled Trial. Pediatrics. 2008;122:693-700.
Samanta M, Sarkar M, Ghosh P, Ghosh JK, Sinha MK, Chatterjee S. Prophylactic probiotics for prevention of necrotizing enterocolitis in very low birth weight newborns. Journal of Tropical Pediatrics. 2009;55(2):128-31.
Janvier A, Malo J, Barrington KJ. Cohort Study of Probiotics in a North American Neonatal Intensive Care Unit. Journal of Pediatrics. 2014;164:980-5.
Raguž JM, Brzica J, Rozić S, Glamuzina SD, Mustapić A et al. The impact of probiotics (Lactobacillus reuteri Protectis) on the treatment, course and outcome of premature infants in the Intensive Care Unit in Mostar. J Pediatr Neonat Individual Med. 2016;5(2):e050228.
Shashidar A, Rao PNS. Probiotics for Promoting Feed Tolerance in Very Low Birth Weight Neonates A Randomized Controlled Trial. Indian Pediatr. 2017;54(5):363-7.