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. 2024 Sep 5;16(17):2995.
doi: 10.3390/nu16172995.

Impact of Clinical Use of Probiotics on Preterm-Related Outcomes in Infants with Extremely Low Birth Weight

Wei-Hung Wu  1 , Ming-Chou Chiang  1 , Ren-Huei Fu  1 , Mei-Yin Lai  1 , I-Hsyuan Wu  1 , Reyin Lien  1 , Chien-Chung Lee  1
Affiliations

Impact of Clinical Use of Probiotics on Preterm-Related Outcomes in Infants with Extremely Low Birth Weight

Wei-Hung Wu et al. Nutrients. .

Abstract

Background: Preterm birth significantly contributes to mortality and morbidities, with recent studies linking these issues to gut microbiota imbalances. Probiotic supplementation shows promise in mitigating adverse outcomes in preterm infants, but optimal timing and guidelines remain unclear. This study assesses the benefits of probiotic supplementation for preterm infants without consistent guidelines. Methods: This retrospective study examined extremely low-birth-weight (ELBW) infants in neonatal intensive care units from 2017 to 2021. Mortality and preterm-related outcomes were compared between infants receiving probiotics and those not. Subgroup analyses based on probiotic initiation timing were conducted: early (≤14 days), late (>14 days), and non-probiotic groups. Results: The study included 330 ELBW infants: 206 received probiotics (60 early, 146 late), while 124 did not. Probiotic supplementation was associated with lower overall mortality (adjusted OR 0.22, 95% CI 0.09-0.48) and decreased mortality from necrotizing enterocolitis (NEC) or late-onset sepsis (LOS) (adjusted OR 0.12, 95% CI 0.03-0.45). Early probiotics reduced overall mortality, NEC/LOS-related mortality, and NEC/LOS-unrelated mortality. Late probiotics decreased overall mortality and NEC/LOS-related mortality. Early probiotic use also expedited full enteral feeding achievement. Conclusions: Probiotic supplementation reduces mortality and improves feeding tolerance in preterm infants. Establishing guidelines for probiotic use in this population is crucial.

Keywords: extremely low birth weight; mortality; probiotics.

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Conflict of interest statement

The authors that there are no conflicts of interest associated with this research.

Figures

Figure 1
Figure 1
The flow chart of the study.
Figure 2
Figure 2
The time–percentage curve illustrates the progression of complete enteral feeding among three groups. The p-values were adjusted for birth body weight (BBW), exclusive human milk (eHM) feeding, ligation for hemodynamically significant patent ductus arteriosus (HsPDA), and 1 min Apgar score.
See this image and copyright information in PMC

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