Dual-strain probiotics reduce NEC, mortality and neonatal bloodstream infections among extremely low birthweight infants

Denkel, Luisa A.; Schwab, Frank J.; Garten, Lars; Geffers, Christine; Gastmeier, Petra; Piening, Brar

doi:10.1136/archdischild-2017-313897

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…In addition, two large cohort studies have shown a lower incidence of NEC in extremely preterm infants receiving probiotics. 74,78 HOW DO PROBIOTICS WORK?…”

Section: Do Probiotics Prevent Disease In Preterm Infants?mentioning

confidence: 99%

“…50,93,94 As noted above, early analyses suggested that the most premature infants may not benefit from probiotic administration 95 ; however, the largest observational study to date, including 4683 infants with birth weight <1000 g, demonstrated a decrease in the incidence of NEC and death with probiotic administration in this more immature group of infants. 70,74,78 Several studies have demonstrated cross-contamination with probiotics within a given neonatal intensive care unit (NICU) wherein the probiotic strain has been isolated from the feces of infants who did not receive the probiotic. This suggests that probiotic microbes are passed from infant to infant or from care provider to infant in the NICU.…”

Section: Are Probiotics Safe For Preterm Infants?mentioning

confidence: 99%

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Safety and efficacy of probiotic administration to preterm infants: ten common questions

Underwood

Umberger²,

Patel

2020

Pediatr Res

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In spite of a large number of randomized placebo-controlled clinical trials and observational cohort studies including >50,000 preterm infants from 29 countries that have demonstrated a decrease in the risk of necrotizing enterocolitis, death, and sepsis, routine prophylactic probiotic administration to preterm infants remains uncommon in much of the world. This manuscript reflects talks given at the NEC Society Symposium in 2019 and is not intended to be a state-of-the-art review or systematic review, but a summary of the probiotic-specific aspects of the symposium with limited additions including a recent strain-specific network analysis and position statement from the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). We address ten common questions related to the intestinal microbiome and probiotic administration to the preterm infant.

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“…In addition, two large cohort studies have shown a lower incidence of NEC in extremely preterm infants receiving probiotics. 74,78 HOW DO PROBIOTICS WORK?…”

Section: Do Probiotics Prevent Disease In Preterm Infants?mentioning

confidence: 99%

Section: Are Probiotics Safe For Preterm Infants?mentioning

confidence: 99%

Safety and efficacy of probiotic administration to preterm infants: ten common questions

Underwood

Umberger²,

Patel

2020

Pediatr Res

View full text Add to dashboard Cite

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Effects of neonatal nutrition interventions on neonatal mortality and child health and development outcomes: A systematic review

Imdad

Rehman

Davis

et al. 2021

Campbell Systematic Reviews

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Background The last two decades have seen a significant decrease in mortality for children <5 years of age in low and middle‐income countries (LMICs); however, neonatal (age, 0–28 days) mortality has not decreased at the same rate. We assessed three neonatal nutritional interventions that have the potential of reducing morbidity and mortality during infancy in LMICs. Objectives To determine the efficacy and effectiveness of synthetic vitamin A, dextrose oral gel, and probiotic supplementation during the neonatal period. Search Methods We conducted electronic searches for relevant studies on the following databases: PubMed, CINAHL, LILACS, SCOPUS, and CENTRAL, Cochrane Central Register for Controlled Trials, up to November 27, 2019. Selection Criteria We aimed to include randomized and quasi‐experimental studies. The target population was neonates in LMICs. The interventions included synthetic vitamin A supplementation, oral dextrose gel supplementation, and probiotic supplementation during the neonatal period. We included studies from the community and hospital settings irrespective of the gestational age or birth weight of the neonate. Data Collection and Analysis Two authors screened the titles and extracted the data from selected studies. The risk of bias (ROB) in the included studies was assessed according to the Cochrane Handbook of Systematic Reviews. The primary outcome was all‐cause mortality. The secondary outcomes were neonatal sepsis, necrotizing enterocolitis (NEC), prevention and treatment of neonatal hypoglycaemia, adverse events, and neurodevelopmental outcomes. Data were meta‐analyzed by random effect models to obtain relative risk (RR) and 95% confidence interval (CI) for dichotomous outcomes and mean difference with 95% CI for continuous outcomes. The overall rating of evidence was determined by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Main Results Sixteen randomized studies (total participants 169,366) assessed the effect of vitamin A supplementation during the neonatal period. All studies were conducted in low‐ and middle‐income (LMIC) countries. Thirteen studies were conducted in the community setting and three studies were conducted in the hospital setting, specifically in neonatal intensive care units. Studies were conducted in 10 different countries including India (four studies), Guinea‐Bissau (three studies), Bangladesh (two studies), and one study each in China, Ghana, Indonesia, Nepal, Pakistan, Tanzania, and Zimbabwe. The overall ROB was low in most of the included studies for neonatal vitamin A supplementation. The pooled results from the community based randomized studies showed that there was no significant difference in all‐cause mortality in the vitamin A (intervention) group compared to controls at 1 month (RR, 0.99; 95% CI, 0.90–1.08; six studies with 126,548 participants, statistical heterogeneity I2 0%, funnel plot symmetrical, grade rating high), 6 months (RR, 0.98; 95% CI, 0.89–1.07; 12 studies with 154,940 participan...

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Recent Advances in Prevention and Therapies for Clinical or Experimental Necrotizing Enterocolitis

2019

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Dual-strain probiotics reduce NEC, mortality and neonatal bloodstream infections among extremely low birthweight infants

Cited by 4 publications

References 3 publications

Safety and efficacy of probiotic administration to preterm infants: ten common questions

Safety and efficacy of probiotic administration to preterm infants: ten common questions

Effects of neonatal nutrition interventions on neonatal mortality and child health and development outcomes: A systematic review

Recent Advances in Prevention and Therapies for Clinical or Experimental Necrotizing Enterocolitis

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