Neonatology Fellowship Program Director Texas A&M Health Science Center College of Medicine Temple, Texas, United States
Background: Because of their immature guts, preterm babies are more likely to have growth limitation and nutritional deficiencies. Due to variations in gestational age (GA) and products provided, the effects of probiotics on the growth metrics and intestinal microbiota of premature infants have been inconsistent. Objective: To assess the effects of probiotics on the growth of preterm infants (less than 1500g or less than 32 weeks gestational age). Design/Methods: A retrospective cohort study was conducted on neonates admitted to the neonatal intensive care unit (NICU) of Scott & White Memorial Hospital with birth weights less than 1500 grams. Pre-probiotic (January 2017–September 2018) and post-probiotic (October 2018–December 2022) data collection periods were observed. Excluded were infants who had multiple congenital defects, had undergone intestinal surgery or an ostomy, were delivered at an outside hospital, or had passed away before being released from the NICU. Weight, length, and head circumference were the three growth metrics that were compared at birth, discharge, and six months. After controlling for other variables, the impact of probiotics on outcomes was evaluated using linear regressions. Results: 350 of the 554 newborns who fulfilled the eligibility requirements were administered probiotics. When comparing the probiotics group to the non-probiotics group, the median gestational age was 27.6 weeks (22–34.0) as opposed to 28.6 weeks (22–1-34.5). 1064 grams (440–1500) was the median birthweight, compared to 1032 grams (378–1500). Prior to receiving probiotics, 6 (4%) infants were diagnosed with necrotizing enterocolitis (NEC), however there were 0 cases afterward (p=0.045). The average growth in weight (-0.15 lbs), length (-0.20 in), and head circumference (-.04 cm) was somewhat lower in probiotic-treated newborns at discharge; however, these differences were not statistically significant. Additionally, at six months, babies who took probiotics grew longer (+0.29 in, p=0.1) and had a slightly larger head circumference (+0.21 in, p=0.3) than babies who did not receive probiotics. The probiotic group gained 3.30 kg at six months, while the non-probiotic group gained 3.22 kg (p=0.4). These differences in median weight gain were not statistically significant.
Conclusion(s): When comparing infants who received probiotics to those who did not, the growth of the former group was somewhat higher at six months. NEC rates in the probiotics group were significantly lower. To find out how probiotics affect growth in the long run, more time must be spent monitoring the patient.
