Armanian Amir-Mohammad, Sadeghnia Alireza, Hoseinzadeh Maryam, Mirlohi Maryam, Feizi Awat, Salehimehr Nima, Saee Najme, Nazari Jila
Department of Pediatrics, Division of Neonatology, Child Growth and Development Research Center, Research Institute for Primary Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2014 Nov;5(11):1387-95.
Necrotizing enterocolitis (NEC) is one of the most destructive diseases associated with conditions of neonatal prematurity. Supplementation with enteral prebiotics may reduce the incidence of NEC, especially in infants who fed exclusively with breast-milk. Therefore, we compared the efficacy and safety of enteral supplementation of a prebiotic mixture (short chain galacto-oligosaccharides/long chain fructo-oligosaccharides [SCGOS/LCFOS]) versus no intervention on incidence of NEC in preterm infants.
In a single-center randomized control trial 75 preterm infants (birth weight [BW] ≤1500 g, gestational age ≤34 weeks and were not fed with formula) on 30 ml/kg/day volume of breast-milk were randomly allocated to have enteral supplementation with a prebiotic mixture (SCGOS/LCFOS; 9:1) or not receive any prebiotic. The incidence of suspected NEC, feeding intolerance, time to full enteral feeds, duration of hospitalization were investigated.
Differences in demographic characteristics were not statistically important. SCGOS/LCFOS mixture significantly reduced the incidence of suspected NEC, (1 [4.0%] vs. 11 [22.0%]; hazard ratio: 0.49 [95% confidence interval: 0.29-0.84]; P = 0.002), and time to full enteral feeds (11 [7-21] vs. 14 [8-36] days; P - 0.02]. Also duration of hospitalization was meaningfully shorter in the prebiotic group (16 [9-45] vs. 25 [11-80]; P - 0.004]. Prebiotic oligosaccharides were well tolerated by very low BW (VLBW) infants.
Enteral supplementation with prebiotic significantly reduced the incidence of NEC in VLBW infants who were fed exclusively breast-milk. This finding suggests that it might have been the complete removal of formula which caused a synergistic effect between nonhuman neutral oligosaccharides (prebiotic) and human oligosaccharides.
坏死性小肠结肠炎（NEC）是与新生儿早产状况相关的最具破坏性的疾病之一。补充肠道益生元可能会降低NEC的发病率，尤其是在纯母乳喂养的婴儿中。因此，我们比较了肠道补充益生元混合物（短链低聚半乳糖/长链低聚果糖[SCGOS/LCFOS]）与不进行干预对早产儿NEC发病率的疗效和安全性。
在一项单中心随机对照试验中，75名早产婴儿（出生体重[BW]≤1500g，胎龄≤34周且未喂配方奶），以30ml/kg/天的母乳量喂养，被随机分配接受肠道补充益生元混合物（SCGOS/LCFOS；9:1）或不接受任何益生元。研究了疑似NEC的发病率、喂养不耐受情况、完全经口喂养的时间、住院时间。
人口统计学特征差异无统计学意义。SCGOS/LCFOS混合物显著降低了疑似NEC的发病率（1例[4.0%]对11例[22.0%]；风险比：0.49[95%置信区间：0.29 - 0.84]；P = 0.002），以及完全经口喂养的时间（11天[7 - 21天]对14天[8 - 36天]；P = 0.02）。益生元组的住院时间也明显更短（16天[9 - 45天]对25天[11 - 80天]；P = 0.004）。极低出生体重（VLBW）婴儿对益生元低聚糖耐受性良好。
肠道补充益生元显著降低了纯母乳喂养的VLBW婴儿的NEC发病率。这一发现表明，可能是完全去除配方奶导致了非人类中性低聚糖（益生元）和人类低聚糖之间的协同作用。
