Probiotics use tied to Reduced Mortality in Preterm Infants: Study
According to a Canadian retrospective cohort study the use of probiotics in neonatal units was associated with decreased mortality in preterm and low-birth-weight infants. However Probiotic use did not significantly impact rates of necrotizing enterocolitis (NEC) or late-onset sepsis. Despite no change in NEC or sepsis rates, overall mortality was lower in infants who received probiotics. Results derived from information on more than 32,000 preterm infants, underscore the potential advantages and hazards of NICU use of probiotics. Pharmaceutical-grade probiotic access concerns, doubts about efficacy, and the possibility of probiotic sepsis have curative adoption on a large scale. The study was published in the journal Pediatrics.
The study reviewed data from 32,667 preterm babies, born under 34 weeks of gestational age; all were admitted in 33 NICUs across Canada between January 2016 and December 2022. Excluded from the analysis at admission were moribund infants, those who succumbed to death in the first two days, those admitted beyond two days after birth, those with severe congenital anomalies, and those for whom enteral feeds were never initiated.
Among the infants who were included, 57.5% were administered probiotics with a median gestational age of 29 weeks, whereas 42.5% were not, and the median gestational age was 31 weeks. The researchers performed adjusted analyses to assess the relationship between the use of probiotics and clinical outcomes such as mortality, NEC, late-onset sepsis, and probiotic sepsis.
Key Finding
• Probiotic treatment was linked to a 38% decrease in mortality in all infants born prior to 34 weeks' gestation (adjusted odds ratio [aOR] 0.62, 98.3% confidence interval [CI] 0.53-0.73).
• In infants with birth weight <1,000 g, probiotic treatment was associated with a 42% decrease in mortality (aOR 0.58, 98.3% CI 0.47-0.71).
• There was no significant decrease found in the incidence of NEC in all preterm infants (aOR 0.92, 98.3% CI 0.78-1.09) or birth weight <1,000 g (aOR 0.90, 98.3% CI 0.71-1.13).
• No reduction in late-onset sepsis was found among preterm infants (aOR 0.90, 98.3% CI 0.80-1.01) or birth weight <1,000 g (aOR 1.01, 98.3% CI 0.86-1.18).
• Probiotic sepsis was uncommon, occurring in 27 infants born at <34 weeks' gestation and 20 infants with a birth weight of <1,000 g. Three infants with probiotic sepsis died, and the condition was considered a potential cause in two.
The study authors concluded that probiotics can significantly decrease mortality in preterm and low-birth-weight neonates but do not lower the rate of NEC or late-onset sepsis considerably. The result emphasizes the role of probiotics in neonatal management while being mindful of the necessity for ongoing caution about probiotic-related risk, especially probiotic sepsis. More research is needed to make probiotics more precise in NICU practice and provide definite guidelines for their efficient and safe application.
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