Outcomes in preterm small versus appropriate for gestation infants after Bifidobacterium breve M-16 V supplementation

Abstract

Introduction: Fecal bifidobacteria response after Bifidobacterium breve M-16 V supplementation was comparable in preterm small (SGA) versus appropriate for gestational age (AGA) infants.

Objectives: To compare clinical outcomes between preterm SGA versus AGA infants after routine probiotic supplementation (RPS) with Bifidobacterium breve M-16V (3 × 10⁹ CFU/day).

Design: Retrospective cohort study (June 2012–August 2015) comparing outcomes between preterm (<34 weeks, subgroup: <29 weeks) SGA versus AGA infants after RPS with B. breve M-16 V using multivariable regression analysis. Primary outcome: necrotizing enterocolitis (NEC)≥Stage II/all-cause mortality. Secondary outcomes: NEC ≥ Stage II, all-cause mortality, late onset sepsis (LOS), postnatal age at full feeds (PAFF).

Results: Outcomes in inborn 1380/1481 (162 SGA versus 1218 AGA) admissions were analyzed. Primary outcome “NEC ≥ Stage II /all-cause mortality” was higher in SGA versus AGA infants <29 weeks (21 versus 12%; p = .040), and showed trend toward reduction (8 versus 6%; p = .057) in AGA <34 weeks. NEC ≥ Stage II, LOS, and all-cause mortality was comparable in SGA versus AGA infants <34 weeks (3 versus 2, 9 versus 8, 9% versus 6%) and <29 weeks (5 versus 4, 16 versus 9, 18% versus 19%), respectively. Median (IQR) PAFF was significantly higher in SGA versus AGA infants <34 weeks (8 (6–12) versus 7 (5–10) days), and <29 weeks (14 (12–17) versus 11 (8–16) days).

Conclusions: NEC, LOS and all-cause mortality rates were similar in preterm SGA versus AGA infants after RPS with Bifidobacterium breve M-16 V, but PAFF was higher in SGA infants.

Keywords:

• Bifidobacterium breve M-16 V
• preterm
• probiotic
• small for gestation age

Acknowledgements

The authors express their gratitude to Mr Damber Shrestha, the neonatal database manager at the Neonatal Directorate, King Edward Memorial Hospital, for his assistance with extracting relevant data for the study.

Disclosure statement

No potential conflict of interest was reported by the authors.