Nasief Hisham, Alaifan Meshari A, Tamur Shadi, Khadawardi Khalid, Bahauddin Ammar A, Ahmed Aijaz, Ahmad Sarfraz, Singh Rajinder, Alhussaini Bakr H, Hassan Amber
Departments of Obstetrics and Gynecology and Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Paediatr Int Child Health. 2024 May;44(1):24-29. doi: 10.1080/20469047.2024.2328416. Epub 2024 Mar 14.
Raised serum bilirubin levels can cause kernicterus, and premature infants are at increased risk owing to metabolic immaturity. The standard treatment for neonatal jaundice is phototherapy, but probiotics alone can reduce the duration of phototherapy and hospitalisation.
To determine the effectiveness of phototherapy with and without probiotics for the treatment of indirect hyperbilirubinaemia in preterm neonates.
The open-labelled randomised controlled trial was conducted from January 2022 to January 2023 in the neonatal unit of the University of Lahore Teaching Hospital, Pakistan. A total of 76 preterm neonates who fulfilled the selection criteria were included and divided into two groups. Both groups received standard phototherapy. In Group B, a probiotic () 125 mg, twice daily, orally (in 5 cc of whichever milk the infant was receiving) was given until discharge from hospital. The primary outcome measurements were the duration of phototherapy and the length of hospitalisation.
The mean (SD) duration of phototherapy was 36.55 (14.25) hours in Group A and 24.61 (9.25) hours in Group B ( <0.05). The mean (SD) duration of hospital stay was 47.36 (16.51) hours in Group A and 33.13 (8.93) hours in Group B ( <0.05).
Oral probiotics () have a significant effect on the duration of phototherapy for neonatal hyperbilirubinaemia, and they decrease the chances of nosocomial infection. Exploration of clinical outcomes by investigating faecal flora and undertaking large randomised controlled trials of various probiotics are needed.
ABE: acute bilirubin encephalopathy; CNS: central nervous system; GA: gestational age; IVIG: intravenous immunoglobulin; KSD: kernicterus; NNU: neonatal unit; RCT: randomised controlled trial; S. boulardii: Saccharomyces boulardii.
血清胆红素水平升高可导致核黄疸，由于代谢不成熟，早产儿的风险更高。新生儿黄疸的标准治疗方法是光疗，但单独使用益生菌可缩短光疗时间和住院时间。
确定光疗联合或不联合益生菌治疗早产儿间接高胆红素血症的有效性。
2022年1月至2023年1月在巴基斯坦拉合尔大学教学医院新生儿科进行了开放标签随机对照试验。共有76名符合入选标准的早产儿被纳入并分为两组。两组均接受标准光疗。B组口服益生菌（布拉酵母菌125毫克，每日两次，溶于5毫升婴儿正在食用的任何一种奶中），直至出院。主要观察指标为光疗时间和住院时间。
A组光疗平均（标准差）时间为36.55（14.25）小时，B组为24.61（9.25）小时（P<0.05）。A组平均（标准差）住院时间为47.36（16.51）小时，B组为33.13（8.93）小时（P<0.05）。
口服益生菌（布拉酵母菌）对新生儿高胆红素血症的光疗时间有显著影响，并可降低医院感染的几率。需要通过调查粪便菌群和开展各种益生菌的大型随机对照试验来探索临床结局。
ABE：急性胆红素脑病；CNS：中枢神经系统；GA：胎龄；IVIG：静脉注射免疫球蛋白；KSD：核黄疸；NNU：新生儿科；RCT：随机对照试验；S. boulardii：布拉酵母菌
