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Effects of Lactobacillus reuteri DSM 17938 in preterm infants: a double-blinded randomized controlled study

  • 2019-11-09
  • Italian Journal of Pediatrics 45(1)
    • Xuewei Cui
    • Yongyan Shi
    • Siyang Gao
    • Xindong Xue
    • Jianhua Fu

Abstract

Background: Preterm infants have immature gastrointestinal tracts and poor immunity. In this study, the effects of Lactobacillus reuteri DSM 17938 first on early feeding tolerance, growth, and second on infection prevention in preterm infants were evaluated.

Methods: One hundred fourteen formula-fed preterm infants with a gestational age between 30 weeks and 37 weeks, and a birth weight between 1500 and 2000 g were enrolled; 57 in the intervention and 57 in the control group:the intervention group was given a dose of 1 × 108 colony-forming units (5 drops) of L. reuteri DSM 17938 once daily, beginning with the first feeding until discharge. The control group did not receive probiotics. Early feeding tolerance (as time to full enterla feeding and number of reflux), growth, incidences of sepsis, localized infection, NEC, and adverse effects were recorded for both groups.

Results: The number of Daily reflux episodes (times/d) was lower (2.18 ± 0.83 vs. 3.77 ± 0.66, P < 0.01) and time to full enteral feedings (120 mL/kg/d) (9.95 ± 2.46 d vs. 13.80 ± 3.47 d, P < 0.05) was shorter in the intervention group. Average daily weight gain (14.55 ± 3.07 g/d vs. 10.12 ± 2.80 g/d), head circumference increas e(0.0760 ± 0.0157 cm/d vs. 0.0681 ± 0.0108 cm/d), and body length increase (0.1878 ± 0.0151 cm/d vs. 0.1756 ± 0.0166 cm/d) of the intervention group were higher (P < 0.01). There were no significant differences in the incidences of sepsis (4.44% vs. 8.33%), localized infection (6.67% vs. 8.33%), or NEC (2.22% vs. 10.42%) between the 2 groups (P > 0.05). The number of daily defecations (times/d) in the intervention group was higher (3.08 ± 0.33 vs. 2.29 ± 0.20, P < 0.01) and the length of hospital stay was shorter than that in the control group (20.60 ± 5.36 d vs. 23.75 ± 8.57 d, P < 0.05). No adverse effects were noted among the infants receiving L. reuteri.

Conclusion: L. reuteri may be an useful tool in improving early feeding tolerance in preterm infants, promoting growth, increasing the frequency of defecation, and shortening the length of hospital stay.

Trial registration: ChiCTR, ChiCTR1900025590. Registered 1 February 2019- Retrospectively registered, http://www.chictr.org.cn/listbycreater.aspx.

Keywords: Feeding tolerance; Growth; Infection prevention; Lactobacillus reuteri; Preterm infant.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus reuteri DSM 17938Improved Average Daily GainBeneficial
Large
Lactobacillus reuteri DSM 17938Increased Body LengthBeneficial
Moderate
Lactobacillus reuteri DSM 17938Increased Bowel Movement FrequencyBeneficial
Large
Lactobacillus reuteri DSM 17938Increased Head CircumferenceBeneficial
Moderate
Lactobacillus reuteri DSM 17938No Adverse Health EffectsNeutral
Large
Lactobacillus reuteri DSM 17938Reduced Length of Hospital StayBeneficial
Moderate
Lactobacillus reuteri DSM 17938Reduced Reflux EpisodesBeneficial
Large
Lactobacillus reuteri DSM 17938Reduced Time to Full Enteral FeedingBeneficial
Large
Lactobacillus reuteri NCIMB 30242Improved Average Daily GainBeneficial
Large
Lactobacillus reuteri NCIMB 30242Improved Bowel Movement FrequencyBeneficial
Large
Lactobacillus reuteri NCIMB 30242Increased Body LengthBeneficial
Moderate
Lactobacillus reuteri NCIMB 30242Increased Head CircumferenceBeneficial
Moderate
Lactobacillus reuteri NCIMB 30242Reduced Hospitalization DurationBeneficial
Moderate
Lactobacillus reuteri NCIMB 30242Reduced Reflux EpisodesBeneficial
Large
Lactobacillus reuteri NCIMB 30242Reduced Time to Full Enteral FeedingBeneficial
Large
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