- Alshaikh BN, et al. Pediatrics. https://bit.ly/4hWwKpy.
A retrospective study of more than 32,000 preterm infants admitted to neonatal intensive care units (NICUs) in Canada found the use of probiotics was associated with decreased mortality rates.
The study sought to evaluate the effectiveness of probiotic supplements added to breast milk or formula for infants born before 34 weeks’ gestation, including those with an extremely low birth weight (ELBW) of less than 1,000 grams (2.2 pounds).
Of 32,667 eligible infants born at 33 NICUs between Jan. 1, 2016, and Dec. 31, 2022, 18,793 (57.5%) received probiotics and 13,874 (42.5%) did not.
The probiotic cohort had decreased mortality rates (adjusted odds ratio [aOR], 0.62; 98.3% Cl, 0.53-.073) but not decreased rates of necrotizing enterocolitis (NEC) (aOR, 0.92; 98.3% Cl, 0.78-1.09) or late-onset sepsis (aOR, 0.90; 98.3% Cl, 0.80-1.01).
Of the total dataset, 7,401 infants had ELBW and 2,465 (33.3%) of those received probiotics. In that cohort, probiotics again were found to be associated with decreased mortality rates (aOR, 0.58; 98.3% Cl, 0.47-.071) but not decreased NEC (aOR, 0.90; 98.3% Cl, 0.71-1.13) or late-onset sepsis (aOR, 1.01; 98.3% Cl, 0.86-1.18).
“In the group with a birth weight less than 1,000 g, all-cause death was lower among infants who received probiotics than those in the nonprobiotics group,” the authors wrote. “All-cause mortality was comparable between the two groups in the whole cohort.”
The authors noted that incidents of probiotic sepsis have prompted federal warnings about probiotic use in NICUs. The study found such incidents to be rare, occurring in 27 infants. Three died within seven days, and probiotic sepsis was considered a possible cause of death in two of them.
“The risk of probiotic sepsis should be weighed against the risks of other interventions that preterm infants are exposed to, such as central venous catheterization,” the authors wrote. “Moreover, benefits regarding mortality must also be weighed in the equation.”
