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Necrotising enterocolitis and mortality in preterm infants after introduction of probiotics: a quasi-experimental study.


ABSTRACT: Evidence on the clinical effectiveness of probiotics in the prevention of necrotising enterocolitis (NEC) in preterm infants is conflicting and cohort studies lacked adjustment for time trend and feeding type. This study investigated the association between the introduction of routine probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum; Infloran(®)) on the primary outcome 'NEC or death'. Preterm infants (gestational age <32 weeks or birth weight <1500?gram) admitted before (Jan 2008-Sep 2012; n?=?1288) and after (Oct 2012-Dec 2014; n?=?673) introduction of probiotics were compared. Interrupted time series logistic regression models were adjusted for confounders, effect modification by feeding type, seasonality and underlying temporal trends. Unadjusted and adjusted analyses showed no difference in 'NEC or death' between the two periods. The overall incidence of NEC declined from 7.8% to 5.1% (OR 0.63, 95% CI 0.42-0.93, p?=?0.02), which was not statistically significant in the adjusted models. Introduction of probiotics was associated with a reduced adjusted odds for 'NEC or sepsis or death' in exclusively breastmilk-fed infants (OR 0.43, 95% CI 0.21-0.93, p?=?0.03) only. We conclude that introduction of probiotics was not associated with a reduction in 'NEC or death' and that type of feeding seems to modify the effects of probiotics.

SUBMITTER: Samuels N 

PROVIDER: S-EPMC4992873 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Necrotising enterocolitis and mortality in preterm infants after introduction of probiotics: a quasi-experimental study.

Samuels Noor N   van de Graaf Rob R   Been Jasper V JV   de Jonge Rogier C J RC   Hanff Lidwien M LM   Wijnen René M H RM   Kornelisse René F RF   Reiss Irwin K M IK   Vermeulen Marijn J MJ  

Scientific reports 20160822


Evidence on the clinical effectiveness of probiotics in the prevention of necrotising enterocolitis (NEC) in preterm infants is conflicting and cohort studies lacked adjustment for time trend and feeding type. This study investigated the association between the introduction of routine probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum; Infloran(®)) on the primary outcome 'NEC or death'. Preterm infants (gestational age <32 weeks or birth weight <1500 gram) admitted before (Jan 200  ...[more]

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