Effect of oral probiotics supplementation in the prevention of necrotizing enterocolitis among very low birth weight preterm infants.
BACKGROUND
Necrotizing enterocolitis (NEC) is the most serious gastrointestinal problem in very low birth weight preterm infants. Multiple risk factors activate the inflammatory cascade leading to high expressions of pro-inflammatory mediators causing bowel injury in NEC. The anti-inflammatory effect of probiotics is due to the inhibition and reduction of inflammatory signal in intestinal epithelium.


OBJECTIVE
To evaluate the efficacy of probiotics supplementation in the prevention of NEC among very low birth weight preterm infants.


METHODS
A prospective randomized controlled trial.


METHODS
All preterm infants with gestational age less than or equal to 34 weeks and birth weight less than or equal to 1,500 grams admitted in neonatal care unit, Queen Sirikit National Institute of Child Health during June 1st, 2012 and January 31th, 2013 were enrolled in this study. They were randomized into two groups, study and control group. Infants in the study group were fed Infloran (Lactobacillus acidophilus 1 x 10(9) and Bifidobacterium bifidum 1 x 10(9) organisms) dose 125 mg/kg/dose twice a day with breast milk or premature formula from the start of feeding until 6 weeks or discharge. Infants in the control group were fed with either breast milk or premature formula alone. The primary outcome was NEC stage ≥ 2.


RESULTS
Sixty infants completed the study, 31 infants in the study group and 29 infants in the control group. The baseline characteristic data of infants were similar except for more males in the present study group. Incidence of NEC stage ≥ 2 were similar in both the groups, 3.2 vs. 3.4% (p = 0.74). There were no deaths during the study period. Days to reach full feeding, 150 ml/kg/day, were no differences between the two groups, 12.03 ± 5.49 days vs. 13.76 ± 8.25 days (p = 0.31). No adverse effects such as sepsis, flatulence or diarrhea were noted.


CONCLUSIONS
In this study, there was no difference in incidence of NEC stage ≥ 2 between the two groups. No adverse effects of probiotics supplementation were observed.
Varaporn
V
Saengtawesin
Raungpung
R
Tangpolkaiwalsak
Wiboon
W
Kanjanapattankul
D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001644:Bifidobacterium / Q000378:metabolism; D001724:Birth Weight; D019587:Dietary Supplements; D020345:Enterocolitis, Necrotizing / Q000517:prevention & control*; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007249:Inflammation / Q000188:drug therapy; D007779:Lactobacillus acidophilus / Q000378:metabolism; D008297:Male; D008895:Milk, Human; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D013501:Surface-Active Agents / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D013501:Surface-Active Agents