Do Oral Probiotics Affect Growth and Neurodevelopmental Outcomes in Very Low-Birth-Weight Preterm Infants?
12 October 2011
27 January 2012
07 May 2012 (online)
Objective To evaluate the growth and neurodevelopment outcomes of very low-birth-weight (VLBW) preterm infants supplemented with oral probiotics for the prevention of necrotizing enterocolitis (NEC).
Study Design This prospective follow-up study was conducted in a cohort of VLBW preterm infants enrolled in a randomized controlled clinical trial to evaluate the efficacy of oral probiotics for the prevention of NEC. Growth outcomes included weight, length, and head circumference. Cognitive and neuromotor development were assessed by using the Bayley Scales of Infant Development II. Sensory and neurological performance was evaluated by standard techniques. The primary outcome was neurodevelopmental impairment at 18 to 22 months' corrected age.
Results A total of 221 infants completed the trial protocol. Of the 208 infants eligible for follow-up, 174 infants (86 in the probiotics group and 88 in the control group) were evaluated. There was no significant difference in growth and neurodevelopmental outcomes between the two groups.
Conclusion Oral probiotic administered to VLBW infants to reduce the incidence and severity of NEC started with the first feed did not affect growth, neuromotor, neurosensory, and cognitive outcomes at 18 to 22 months' corrected age.
- 1 Martin CR, Walker WA. Probiotics: role in pathophysiology and prevention in necrotizing enterocolitis. Semin Perinatol 2008; 32: 127-137
- 2 Lin HC, Su BH, Chen AC , et al. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics 2005; 115: 1-4
- 3 Lin HC, Hsu CH, Chen HL , et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics 2008; 122: 693-700
- 4 Dani C, Biadaioli R, Bertini G, Martelli E, Rubaltelli FF. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol Neonate 2002; 82: 103-108
- 5 Thompson AM, Bizzarro MJ. Necrotizing enterocolitis in newborns: pathogenesis, prevention and management. Drugs 2008; 68: 1227-1238
- 6 Winkler P, Ghadimi D, Schrezenmeir J, Kraehenbuhl JP. Molecular and cellular basis of microflora-host interactions. J Nutr 2007; 137 (3) (Suppl. 02) 756S-772S
- 7 Schulzke SM, Deshpande GC, Patole SK. Neurodevelopmental outcomes of very low-birth-weight infants with necrotizing enterocolitis: a systematic review of observational studies. Arch Pediatr Adolesc Med 2007; 161: 583-590
- 8 Adams-Chapman I, Stoll BJ. Neonatal infection and long-term neurodevelopmental outcome in the preterm infant. Curr Opin Infect Dis 2006; 19: 290-297
- 9 Smets K, Schwagten B. Postnatal cystic germinolysis and neonatal chronic lung disease: evaluation of risk factors and neurodevelopmental outcome. Acta Paediatr 2000; 89: 1111-1114
- 10 Futagi Y, Toribe Y, Ogawa K, Suzuki Y. Neurodevelopmental outcome in children with intraventricular hemorrhage. Pediatr Neurol 2006; 34: 219-224
- 11 Serdaroglu G, Tekgul H, Kitis O, Serdaroglu E, Gökben S. Correlative value of magnetic resonance imaging for neurodevelopmental outcome in periventricular leukomalacia. Dev Med Child Neurol 2004; 46: 733-739
- 12 Manzoni P, Mostert M, Leonessa ML , et al. Oral supplementation with Lactobacillus casei subspecies rhamnosus prevents enteric colonization by Candida species in preterm neonates: a randomized study. Clin Infect Dis 2006; 42: 1735-1742
- 13 Sari FN, Dizdar EA, Oguz S, Erdeve O, Uras N, Dilmen U. Oral probiotics: Lactobacillus sporogenes for prevention of necrotizing enterocolitis in very low-birth weight infants: a randomized, controlled trial. Eur J Clin Nutr 2011; 65: 434-439
- 14 Kitajima H, Sumida Y, Tanaka R, Yuki N, Takayama H, Fujimura M. Early administration of Bifidobacterium breve to preterm infants: randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 1997; 76: F101-F107
- 15 Ehrenkranz RA, Dusick AM, Vohr BR, Wright LL, Wrage LA, Poole WK. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics 2006; 117: 1253-1261
- 16 Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol 1996; 87: 163-168
- 17 Bayley N. Bayley Scales of Infant Development II. 2nd ed. San Antonio, TX: John Wiley and Sons; 1993
- 18 Kuczmarski RJ, Ogden CL, Grummer-Strawn LM , et al. CDC growth charts: United States. Adv Data 2000; (314) 1-27
- 19 MacFie J, O'Boyle C, Mitchell CJ, Buckley PM, Johnstone D, Sudworth P. Gut origin of sepsis: a prospective study investigating associations between bacterial translocation, gastric microflora, and septic morbidity. Gut 1999; 45: 223-228
- 20 Walsh MC, Kliegman RM, Hack M. Severity of necrotizing enterocolitis: influence on outcome at 2 years of age. Pediatrics 1989; 84: 808-814
- 21 Sonntag J, Grimmer I, Scholz T, Metze B, Wit J, Obladen M. Growth and neurodevelopmental outcome of very low birthweight infants with necrotizing enterocolitis. Acta Paediatr 2000; 89: 528-532
- 22 Hintz SR, Kendrick DE, Stoll BJ , et al; NICHD Neonatal Research Network. Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis. Pediatrics 2005; 115: 696-703
- 23 Simon NP. Follow-up for infants with necrotizing enterocolitis. Clin Perinatol 1994; 21: 411-424
- 24 Salhab WA, Perlman JM, Silver L, Sue Broyles R. Necrotizing enterocolitis and neurodevelopmental outcome in extremely low birth weight infants <1000 g. J Perinatol 2004; 24: 534-540
- 25 Stoll BJ, Hansen NI, Adams-Chapman I , et al; National Institute of Child Health and Human Development Neonatal Research Network. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA 2004; 292: 2357-2365
- 26 Chou IC, Kuo HT, Chang JS , et al. Lack of effects of oral probiotics on growth and neurodevelopmental outcomes in preterm very low birth weight infants. J Pediatr 2010; 156: 393-396
- 27 Lucas A, Morley R, Cole TJ, Gore SM. A randomised multicentre study of human milk versus formula and later development in preterm infants. Arch Dis Child Fetal Neonatal Ed 1994; 70: F141-F146
- 28 Vohr BR, Poindexter BB, Dusick AM , et al; NICHD Neonatal Research Network. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics 2006; 118: e115-e123
- 29 Dusick AM, Poindexter BB, Ehrenkranz RA, Lemons JA. Growth failure in the preterm infant: can we catch up?. Semin Perinatol 2003; 27: 302-310