Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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The Optimal Time for Initiating Probiotics for Preterm and Very-Low-Birth-Weight Infants: A 10-Year Experience in a Single Neonatal Intensive Care Unit

  • JeongHoon Park (Department of Pediatrics, Gyeongsang National University Hospital) ;
  • Jae Young, Cho (Department of Pediatrics, Gyeongsang National University Hospital) ;
  • Jung Sook Yeom (Department of Pediatrics, Gyeongsang National University Hospital) ;
  • Jin Su Jun (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Ji Sook Park (Department of Pediatrics, Gyeongsang National University Hospital) ;
  • Eun Sil Park (Department of Pediatrics, Gyeongsang National University Hospital) ;
  • Ji Hyun Seo (Department of Pediatrics, Gyeongsang National University Hospital) ;
  • Jae Young Lim (Department of Pediatrics, Gyeongsang National University Hospital) ;
  • Chan-Hoo Park (Department of Pediatrics, Gyeongsang National University Changwon Hospital) ;
  • Hyang-Ok Woo (Department of Pediatrics, Gyeongsang National University Hospital)
  • Received : 2022.11.16
  • Accepted : 2023.04.12
  • Published : 2023.05.15
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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.

Keywords

Acknowledgement

Statistical analyses in this study were supported by the Medical Research Statistics Department of the Gyeongsang National University Hospital. Encoded clinical data used in this study were obtained from Gyeongsang National University Hospital, a member of the Korea Biobank Network.

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