Mosapride combined with probiotics on gastrointestinal function and growth in premature infants

Abstract

The aim of this study was to investigate the effects of mosapride combined with probiotics on gastrointestinal function and growth and development in premature infants. A total of 240 premature infants treated at Weifang People's Hospital between June 2012 and May 2015 who matched our criteria were randomly divided into three groups of 80 cases each. Group A received routine treatment, group B received routine treatment combined with live B. subtilis and E. faecium granules with multivitamins (Medilac-Vita), and group C received routine treatment and Saccharomyces boulardii sachets (Bioflor). Mosapride was administered to patients in groups B and C to promote intestinal peristalsis. Gastrin and bilirubin levels, as well as jaundice fade time, were recorded. Growth and development condition (i.e., head circumference and weight), duration and incidence of feeding intolerance (FI), as well as other symptoms were also analyzed. By day 14, gastrin concentrations in groups B and C were significantly higher than those in group A (P<0.05). Serum bilirubin levels in groups B and C showed a progressive decline from day 7 to day 14, and jaundice duration in group A was significantly longer (P<0.05). Furthermore, at 2 weeks, the average weight growth rate and head circumference were significantly greater in groups B and C, weight loss recovery time was shorter, and EUGR incidence was lower (P<0.05). The incidence rate of gastric retention and FI were lower in groups B and C than group A (P<0.05), and neonatal hyperbilirubinemia, parenteral nutrition-associated cholestasis, necrotizing enterocolitis, and neonatal sepsis incidence was significantly lower in groups B and C (P<0.05). Mosapride combined with probiotics can effectively reduce FI incidence in premature infants, shorten enteral feeding time, promote the absorption of required nutrients, and promote the development and recovery of early physiological weight loss in preterm infants.

Probiotics for Preterm Infants

“…1. In total 56 articles (for 49 different RCTs) were identified which fulfilled our inclusion criteria and reported usable extractable outcome data on at least 1 of our predefined outcome domains (51–106). Five of these articles only showed overlapping data and were further discarded (102–106).…”

“…The studies from which no suitable data on our outcome domains could be extracted were therefore excluded from further analysis in this report (107–120). From the 51 included articles (51–101), data from 11,231 preterm infants could potentially be extracted. Table 1 shows study details and main characteristics of the included patients.…”

“…The small differences can be explained due to the Bayesian statistical approach versus the classic frequentist randomeffects models, but it is known that Bayesian techniques better account for trial heterogeneity. In addition, the NMA gained extra power from indirect network evidence, from studies in which there was no suitable placebo group but only provided head-to-head comparisons (96,101), and from studies in which data from multiple treatment arms could be included (66,84). Unfortunately, most network evidence was based on indirect comparisons as the vast majority only compared treatment versus placebo or routine care.…”

Probiotics for Preventing Necrotizing Enterocolitis in Preterm Infants: A Network Meta-Analysis

“…The results of our main analysis, performed regardless of infants’ feeding characteristics, were only partially overlapping with the strain-specific NMA performed by the ESPGHAN working group [ 16 ] since we included different and updated RCTs, some of which evaluated new probiotic treatments [ 33 , 36 , 40 , 43 , 44 , 46 , 48 , 50 , 57 , 73 , 76 ]. Furthermore, we did not include studies where probiotics were used together with other products [ 79 , 80 ] and we focused on RCTs for which outcome data according to feeding type were available.…”

Probiotics and Preterm Infants

“…The GRADE evidence Table as to whether S boulardii CNCM I-745 versus usual care should be used for preterm infants is depicted in Table 7 (134)(135)(136)(137)(138). None of the 3 outcomes show a clear direction of effect when credible intervals are considered, although both the outcomes on mortality and NEC were underpowered.…”