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Outcomes in preterm small versus appropriate for gestation infants after Bifidobacterium breve M-16 V supplementation

  • 2018-11-22
  • The Journal of Maternal-Fetal & Neonatal Medicine 33(13)
    • G. Athalye-Jape
    • N. Minaee
    • E. Nathan
    • K. Simmer
    • S. Patole

Abstract

Introduction: Fecal bifidobacteria response after Bifidobacterium breve M-16 V supplementation was comparable in preterm small (SGA) versus appropriate for gestational age (AGA) infants.Objectives: To compare clinical outcomes between preterm SGA versus AGA infants after routine probiotic supplementation (RPS) with Bifidobacterium breve M-16V (3 × 109 CFU/day).Design: Retrospective cohort study (June 2012-August 2015) comparing outcomes between preterm (<34 weeks, subgroup: <29 weeks) SGA versus AGA infants after RPS with B. breve M-16 V using multivariable regression analysis. Primary outcome: necrotizing enterocolitis (NEC)≥Stage II/all-cause mortality. Secondary outcomes: NEC ≥ Stage II, all-cause mortality, late onset sepsis (LOS), postnatal age at full feeds (PAFF).Results: Outcomes in inborn 1380/1481 (162 SGA versus 1218 AGA) admissions were analyzed. Primary outcome "NEC ≥ Stage II /all-cause mortality" was higher in SGA versus AGA infants <29 weeks (21 versus 12%; p = .040), and showed trend toward reduction (8 versus 6%; p = .057) in AGA <34 weeks. NEC ≥ Stage II, LOS, and all-cause mortality was comparable in SGA versus AGA infants <34 weeks (3 versus 2, 9 versus 8, 9% versus 6%) and <29 weeks (5 versus 4, 16 versus 9, 18% versus 19%), respectively. Median (IQR) PAFF was significantly higher in SGA versus AGA infants <34 weeks (8 (6-12) versus 7 (5-10) days), and <29 weeks (14 (12-17) versus 11 (8-16) days).Conclusions: NEC, LOS and all-cause mortality rates were similar in preterm SGA versus AGA infants after RPS with Bifidobacterium breve M-16 V, but PAFF was higher in SGA infants.

Keywords: Bifidobacterium breve M-16 V; preterm; probiotic; small for gestation age.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Bifidobacterium breveIncreased Late-Onset Sepsis IncidenceNeutral
Small
Bifidobacterium breveNEC Stage II or HigherNeutral
Small
Bifidobacterium breveReduced All-Cause MortalityNeutral
Moderate
Bifidobacterium breveTime to Full Enteral Feeding in Postnatal AgeHarmful
Moderate
Bifidobacterium breve Bb-03Necrotizing Enterocolitis Stage II or HigherNeutral
Moderate
Bifidobacterium breve Bb-03Time to Full Enteral Feeding in Postnatal AgeHarmful
Moderate
Bifidobacterium breve Bbr8Increased Late-Onset Sepsis IncidenceNeutral
Small
Bifidobacterium breve Bbr8Reduced All-Cause MortalityNeutral
Moderate
Bifidobacterium breve Bbr8Reduced Necrotising EnterocolitisNeutral
Small
Bifidobacterium breve Bbr8Time to Full Enteral Feeding in Postnatal AgeHarmful
Moderate
Bifidobacterium breve IDCC 4401Increased Late-Onset Sepsis IncidenceNeutral
Small
Bifidobacterium breve IDCC 4401Reduced All-Cause MortalityNeutral
Moderate
Bifidobacterium breve IDCC 4401Reduced Risk of Necrotizing EnterocolitisNeutral
Small
Bifidobacterium breve IDCC 4401Time to Full Enteral Feeding in Postnatal AgeHarmful
Moderate
Bifidobacterium breve M-16VIncreased Late-Onset Sepsis IncidenceNeutral
Small
Bifidobacterium breve M-16VNecrotizing Enterocolitis Stage IINeutral
Small
Bifidobacterium breve M-16VNecrotizing Enterocolitis Stage II or HigherNeutral
Moderate
Bifidobacterium breve M-16VReduced All-Cause MortalityNeutral
Moderate
Bifidobacterium breve M-16VTime to Full Enteral Feeding in Postnatal AgeHarmful
Moderate
Bifidobacterium breve SD5206Advanced Necrotizing EnterocolitisNeutral
Small
Bifidobacterium breve SD5206Increased Late-Onset Sepsis IncidenceNeutral
Small
Bifidobacterium breve SD5206Necrotizing Enterocolitis Stage II or HigherNeutral
Moderate
Bifidobacterium breve SD5206Reduced All-Cause MortalityNeutral
Moderate
Bifidobacterium breve SD5206Time to Full Enteral Feeding in Postnatal AgeHarmful
Moderate
Bifidobacterium breve UABbr-11NEC Stage II or Higher / All-Cause MortalityNeutral
Small
Bifidobacterium breve UABbr-11Reduced Incidence of NEC Stage II or GreaterNeutral
Small
Bifidobacterium breve UABbr-11Time to Full Enteral Feeding in Postnatal AgeHarmful
Moderate
Bifidobacterium breve VPro 52Increased Late-Onset Sepsis IncidenceNeutral
Small
Bifidobacterium breve VPro 52Reduced Incidence of NEC Stage II or GreaterNeutral
Small
Bifidobacterium breve VPro 52Time to Full Enteral Feeding in Postnatal AgeHarmful
Moderate
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