Pediatr Gastroenterol Hepatol Nutr.  2023 May;26(3):146-155. 10.5223/pghn.2023.26.3.146.

The Optimal Time for Initiating Probiotics for Preterm and VeryLow-Birth-Weight Infants: A 10-Year Experience in a Single Neonatal Intensive Care Unit

• Park J
• Cho JY
• Yeom JS
• Jun JS
• Park JS
• Park ES
• Seo JH
• Lim JY
• Park CH
• Woo HO

• KMID: 2542399
• DOI: http://doi.org/10.5223/pghn.2023.26.3.146

Abstract

Purpose
The starting time for probiotic supplementation in preterm infants after birth varies widely. This study aimed to investigate the optimal time for initiating probiotics to reduce adverse outcomes in preterm or very low birth weight (VLBW) infants.
Methods
Medical records of preterm infants born at a gestational age (GA) of <32 weeks or VLBW infants in 2011–2020 were reviewed respectively. The infants who received Saccharomyces boulardii probiotics within 7 days of birth were grouped into an early introduction (EI) group, and those who received supplemented probiotics after 7 days of birth were part of the late introduction (LI) group. Clinical characteristics were compared between the two groups and analyzed statistically.
Results
A total of 370 infants were included. The mean GA (29.1 weeks vs. 31.2 weeks, p<0.001) and birth weight (1,235.9 g vs. 1491.4 g, p<0.001) were lower in the LI group (n=223) than in the EI group. The multivariate analysis indicated that factors affecting the LI of probiotics were GA at birth (odds ratio [OR], 1.52; p<0.001) and the enteral nutrition start day (OR, 1.47; p<0.001). The late probiotic introduction was associated with a risk of late-onset sepsis (OR, 2.85; p=0.020), delayed full enteral nutrition (OR, 5.44; p<0.001), and extrauterine growth restriction (OR, 1.67; p=0.033) on multivariate analyses after adjusting for GA.
Conclusion
Early supplementation of probiotics within a week after birth may reduce adverse outcomes among preterm or VLBW infants.

Keyword

Probiotics; Preterm infant; Very low birth weight infant