The ProPre-Save Study: Effects of Probiotics and Prebiotics Alone or Combined on Necrotizing Enterocolitis in Very Low Birth Weight Infants - 25/02/15
, Banu Aydin, MD 1, Nurdan Dinlen Fettah, MD 1, Elif Özyazıcı, MD 1, Serdar Beken, MD 1, Ayşegül Zenciroğlu, MD 1, Nurullah Okumuş, MD 1, Banu Mutlu Özyurt, MD 2, Mehmet Şah İpek, MD 2, Arzu Akdağ, MD 3, Özden Turan, MD 4, Şenol Bozdağ, MD 5Abstract |
Objective |
To test the efficacy of probiotic and prebiotic, alone or combined (synbiotic), on the prevention of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants.
Study design |
A prospective, randomized, controlled trial was conducted at 5 neonatal intensive care units in Turkey. VLBW infants (n = 400) were assigned to a control group and 3 study groups that were given probiotic (Bifidobacterium lactis), prebiotic (inulin), or synbiotic (Bifidobacterium lactis plus inulin) added to breastmilk or formula for a maximum of 8 weeks before discharge or death. The primary outcome was NEC (Bell stage ≥2).
Results |
The rate of NEC was lower in probiotic (2.0%) and synbiotic (4.0%) groups compared with prebiotic (12.0%) and placebo (18.0%) groups (P < .001). The times to reach full enteral feeding were faster (P < .001), the rates of clinical nosocomial sepsis were lower (P = .004), stays in the neonatal intensive care unit were shorter, (P = .002), and mortality rates were lower (P = .003) for infants receiving probiotics, prebiotics, or synbiotic than controls. The use of antenatal steroid (OR 0.5, 95% CI 0.3-0.9) and postnatal probiotic (alone or in synbiotic) (OR 0.5, 95% CI 0.2-0.8) decreased the risk of NEC, and maternal antibiotic exposure increased this risk (OR 1.9, 95% CI 1.1-3.6).
Conclusions |
In VLBW infants, probiotic (Bifidobacterium lactis) and synbiotic (Bifidobacterium lactis plus inulin) but not prebiotic (inulin) alone decrease NEC.
Le texte complet de cet article est disponible en PDF.Keyword : GI, NEC, NICU, NS, RCT, VLBW
Plan
Vol 166 - N° 3
P. 545 - mars 2015 Retour au numéro
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