Department of Paediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Neonatal and Critical Care Unit, Mater Mothers' Hospital, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2023 May;59(5):760-765. doi: 10.1111/jpc.16390. Epub 2023 Mar 29.
To examine the effect of probiotic administration on the incidence of necrotising enterocolitis (NEC) in preterm infants.
We conducted a retrospective study examining the incidence of NEC in a cohort of infants that received probiotics compared to those that had not, over an 18-year period in a single centre. Infants were included if they were born <32 weeks' gestation with birthweight <1500 g and survived beyond 72 h. Infants in the probiotic group received either ABC Dophilus or Infloran. The primary outcome was the rate of NEC. The main secondary outcomes were late-onset sepsis and mortality. Differences in these outcomes between cohorts were examined in univariate and multivariate analyses, taking account of confounding variables, reporting adjusted odds ratios (aORs) with 95% confidence intervals (CIs).
805 infants were included in the study. Infants receiving probiotics had a lower risk of developing NEC compared with those that did not (32/419 (7.6%) vs. 14/386 (3.6%); aOR 0.37 (95% CI 0.18-0.74)). There was also a reduction in the late-onset sepsis rate (22.4% vs. 14.2%, aOR 0.52, 95% CI 0.35-0.77) and mortality rate (9.5% vs. 4.6%, aOR 0.35, 95% CI 0.17-0.73).
The administration of a multi-organism probiotic formulation, including Bifidobacteria, to very preterm infants in our unit was associated with a reduced incidence of NEC, late-onset sepsis and mortality.
研究益生菌给药对早产儿坏死性小肠结肠炎(NEC)发生率的影响。
我们进行了一项回顾性研究,在单中心 18 年期间,比较了接受益生菌和未接受益生菌的婴儿队列中 NEC 的发生率。纳入标准为胎龄<32 周、出生体重<1500g 且生存时间超过 72 小时的婴儿。益生菌组的婴儿接受 ABC Dophilus 或 Infloran。主要结局是 NEC 的发生率。主要次要结局是晚发性败血症和死亡率。在单变量和多变量分析中,考虑混杂变量,报告调整后的优势比(aOR)及其 95%置信区间(CI),以比较两个队列在这些结局上的差异。
805 名婴儿纳入研究。与未接受益生菌的婴儿相比,接受益生菌的婴儿发生 NEC 的风险较低(32/419(7.6%)比 14/386(3.6%);aOR 0.37(95%CI 0.18-0.74))。晚发性败血症的发生率(22.4%比 14.2%,aOR 0.52,95%CI 0.35-0.77)和死亡率(9.5%比 4.6%,aOR 0.35,95%CI 0.17-0.73)也有所降低。
在我们的单位,给非常早产儿使用包括双歧杆菌在内的多器官益生菌制剂与降低 NEC、晚发性败血症和死亡率的发生率有关。