Lactobacillus acidophilus/bifidobacterium infantis probiotics are beneficial to extremely low gestational age infants fed human milk

Ingmar Fortmann; Janina Marißen; Bastian Siller; Juliane Spiegler; Alexander Humberg; Kathrin Hanke; Kirstin Faust; Julia Pagel; Leila Eyvazzadeh; Kim Brenner; Claudia Roll; Sabine Pirr; Dorothee Viemann; Dimitra Stavropoulou; Philipp Henneke; Birte Tröger; Thorsten Körner; Anja Stein; Christoph Derouet; Michael Zemlin; Christian Wieg; Jan Rupp; Egbert Herting; Wolfgang Göpel; Christoph Härtel

doi:10.3390/nu12030850

Lactobacillus acidophilus/bifidobacterium infantis probiotics are beneficial to extremely low gestational age infants fed human milk

Ingmar Fortmann^*, Janina Marißen, Bastian Siller, Juliane Spiegler, Alexander Humberg, Kathrin Hanke, Kirstin Faust, Julia Pagel, Leila Eyvazzadeh, Kim Brenner, Claudia Roll, Sabine Pirr, Dorothee Viemann, Dimitra Stavropoulou, Philipp Henneke, Birte Tröger, Thorsten Körner, Anja Stein, Christoph Derouet, Michael ZemlinChristian Wieg, Jan Rupp, Egbert Herting, Wolfgang Göpel, Christoph Härtel

^*Korrespondierende/r Autor/-in für diese Arbeit

23 Zitate (Scopus)

Abstract

Objective: To evaluate the nutrition-related effects of prophylactic Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on the outcomes of preterm infants <29 weeks of gestation that receive human milk and/or formula nutrition. We hypothesize that human-milk-fed infants benefit from probiotics in terms of sepsis prevention and growth. Methods: We performed an observational study of the German Neonatal Network (GNN) over a period of six years, between 1 January, 2013 and 31 December, 2018. Prophylactic probiotic use of L. acidophilus/B. infantis was evaluated in preterm infants <29 weeks of gestation (n = 7516) in subgroups stratified to feeding type: (I) Exclusively human milk (HM) of own mother and/or donors (HM group, n = 1568), (II) HM of own mother and/or donor and formula (Mix group, n = 5221), and (III) exclusive exposure to formula (F group, n = 727). The effect of probiotics on general outcomes and growth was tested in univariate models and adjusted in linear/logistic regression models. Results: 5954 (76.5%) infants received L. acidophilus/B. infantis prophylactically for the prevention of necrotizing enterocolitis (NEC). Probiotic use was associated with improved growth measures in the HM group (e.g., weight gain velocity in g/day: effect size B = 0.224; 95% CI: 2.82–4.35; p < 0.001) but not in the F group (effect size B = −0.06; 95% CI: −3.05–0.28; p = 0.103). The HM group had the lowest incidence of clinical sepsis (34.0%) as compared to the Mix group (35.5%) and the F group (40.0%). Only in the Mix group, probiotic supplementation proved to be protective against clinical sepsis (OR 0.69; 95% CI: 0.59–0.79; p < 0.001). Conclusion: Our observational data indicate that the exposure to L. acidophilus/B. infantis probiotics may promote growth in exclusively HM-fed infants as compared to formula-fed infants. To exert a sepsis-preventive effect, probiotics seem to require human milk.

Originalsprache	Englisch
Aufsatznummer	850
Zeitschrift	Nutrients
Jahrgang	12
Ausgabenummer	3
DOIs	https://doi.org/10.3390/nu12030850
Publikationsstatus	Veröffentlicht - 03.2020

Fördermittel

Conflicts of Interest: The authors declare no conflict of interests. GNN is funded by the German Ministry for Education and Research. There has been no involvement in study design, collection of analysis, interpretation of data, writing of the report, and decision to submit the manuscript for publication by the German Ministry for Education and Research. The first version of the manuscript was written by Ingmar Fortmann and Christoph Härtel. No payment, honorarium, grant, or other form of payment has been given to the authors.

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Dieser Output leistet einen Beitrag zu folgendem(n) Ziel(en) für nachhaltige Entwicklung

SDG 3 – Gesundheit und Wohlergehen
SDG 5 – Gender Equality

Strategische Forschungsbereiche und Zentren

Forschungsschwerpunkt: Infektion und Entzündung - Zentrum für Infektions- und Entzündungsforschung Lübeck (ZIEL)

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10.3390/nu12030850

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Fortmann, I., Marißen, J., Siller, B., Spiegler, J., Humberg, A., Hanke, K., Faust, K., Pagel, J., Eyvazzadeh, L., Brenner, K., Roll, C., Pirr, S., Viemann, D., Stavropoulou, D., Henneke, P., Tröger, B., Körner, T., Stein, A., Derouet, C., ... Härtel, C. (2020). Lactobacillus acidophilus/bifidobacterium infantis probiotics are beneficial to extremely low gestational age infants fed human milk. Nutrients, 12(3), Artikel 850. https://doi.org/10.3390/nu12030850

@article{66a73d5ee31d4fe78c2a6b983a2c23cf,

title = "Lactobacillus acidophilus/bifidobacterium infantis probiotics are beneficial to extremely low gestational age infants fed human milk",

abstract = "Objective: To evaluate the nutrition-related effects of prophylactic Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on the outcomes of preterm infants <29 weeks of gestation that receive human milk and/or formula nutrition. We hypothesize that human-milk-fed infants benefit from probiotics in terms of sepsis prevention and growth. Methods: We performed an observational study of the German Neonatal Network (GNN) over a period of six years, between 1 January, 2013 and 31 December, 2018. Prophylactic probiotic use of L. acidophilus/B. infantis was evaluated in preterm infants <29 weeks of gestation (n = 7516) in subgroups stratified to feeding type: (I) Exclusively human milk (HM) of own mother and/or donors (HM group, n = 1568), (II) HM of own mother and/or donor and formula (Mix group, n = 5221), and (III) exclusive exposure to formula (F group, n = 727). The effect of probiotics on general outcomes and growth was tested in univariate models and adjusted in linear/logistic regression models. Results: 5954 (76.5\%) infants received L. acidophilus/B. infantis prophylactically for the prevention of necrotizing enterocolitis (NEC). Probiotic use was associated with improved growth measures in the HM group (e.g., weight gain velocity in g/day: effect size B = 0.224; 95\% CI: 2.82–4.35; p < 0.001) but not in the F group (effect size B = −0.06; 95\% CI: −3.05–0.28; p = 0.103). The HM group had the lowest incidence of clinical sepsis (34.0\%) as compared to the Mix group (35.5\%) and the F group (40.0\%). Only in the Mix group, probiotic supplementation proved to be protective against clinical sepsis (OR 0.69; 95\% CI: 0.59–0.79; p < 0.001). Conclusion: Our observational data indicate that the exposure to L. acidophilus/B. infantis probiotics may promote growth in exclusively HM-fed infants as compared to formula-fed infants. To exert a sepsis-preventive effect, probiotics seem to require human milk.",

author = "Ingmar Fortmann and Janina Mari{\ss}en and Bastian Siller and Juliane Spiegler and Alexander Humberg and Kathrin Hanke and Kirstin Faust and Julia Pagel and Leila Eyvazzadeh and Kim Brenner and Claudia Roll and Sabine Pirr and Dorothee Viemann and Dimitra Stavropoulou and Philipp Henneke and Birte Tr{\"o}ger and Thorsten K{\"o}rner and Anja Stein and Christoph Derouet and Michael Zemlin and Christian Wieg and Jan Rupp and Egbert Herting and Wolfgang G{\"o}pel and Christoph H{\"a}rtel",

note = "Funding Information: Conflicts of Interest: The authors declare no conflict of interests. GNN is funded by the German Ministry for Education and Research. There has been no involvement in study design, collection of analysis, interpretation of data, writing of the report, and decision to submit the manuscript for publication by the German Ministry for Education and Research. The first version of the manuscript was written by Ingmar Fortmann and Christoph H{\"a}rtel. No payment, honorarium, grant, or other form of payment has been given to the authors. Publisher Copyright: {\textcopyright} 2020 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2020",

month = mar,

doi = "10.3390/nu12030850",

language = "English",

volume = "12",

journal = "Nutrients",

issn = "2072-6643",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "3",

}

Fortmann, I , Marißen, J, Siller, B, Spiegler, J, Humberg, A, Hanke, K , Faust, K, Pagel, J, Eyvazzadeh, L, Brenner, K, Roll, C, Pirr, S, Viemann, D, Stavropoulou, D, Henneke, P, Tröger, B, Körner, T, Stein, A, Derouet, C, Zemlin, M, Wieg, C, Rupp, J , Herting, E, Göpel, W & Härtel, C 2020, 'Lactobacillus acidophilus/bifidobacterium infantis probiotics are beneficial to extremely low gestational age infants fed human milk', Nutrients, Jg. 12, Nr. 3, 850. https://doi.org/10.3390/nu12030850

TY - JOUR

T1 - Lactobacillus acidophilus/bifidobacterium infantis probiotics are beneficial to extremely low gestational age infants fed human milk

AU - Fortmann, Ingmar

AU - Marißen, Janina

AU - Siller, Bastian

AU - Spiegler, Juliane

AU - Humberg, Alexander

AU - Hanke, Kathrin

AU - Faust, Kirstin

AU - Pagel, Julia

AU - Eyvazzadeh, Leila

AU - Brenner, Kim

AU - Roll, Claudia

AU - Pirr, Sabine

AU - Viemann, Dorothee

AU - Stavropoulou, Dimitra

AU - Henneke, Philipp

AU - Tröger, Birte

AU - Körner, Thorsten

AU - Stein, Anja

AU - Derouet, Christoph

AU - Zemlin, Michael

AU - Wieg, Christian

AU - Rupp, Jan

AU - Herting, Egbert

AU - Göpel, Wolfgang

AU - Härtel, Christoph

N1 - Funding Information: Conflicts of Interest: The authors declare no conflict of interests. GNN is funded by the German Ministry for Education and Research. There has been no involvement in study design, collection of analysis, interpretation of data, writing of the report, and decision to submit the manuscript for publication by the German Ministry for Education and Research. The first version of the manuscript was written by Ingmar Fortmann and Christoph Härtel. No payment, honorarium, grant, or other form of payment has been given to the authors. Publisher Copyright: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/3

Y1 - 2020/3

N2 - Objective: To evaluate the nutrition-related effects of prophylactic Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on the outcomes of preterm infants <29 weeks of gestation that receive human milk and/or formula nutrition. We hypothesize that human-milk-fed infants benefit from probiotics in terms of sepsis prevention and growth. Methods: We performed an observational study of the German Neonatal Network (GNN) over a period of six years, between 1 January, 2013 and 31 December, 2018. Prophylactic probiotic use of L. acidophilus/B. infantis was evaluated in preterm infants <29 weeks of gestation (n = 7516) in subgroups stratified to feeding type: (I) Exclusively human milk (HM) of own mother and/or donors (HM group, n = 1568), (II) HM of own mother and/or donor and formula (Mix group, n = 5221), and (III) exclusive exposure to formula (F group, n = 727). The effect of probiotics on general outcomes and growth was tested in univariate models and adjusted in linear/logistic regression models. Results: 5954 (76.5%) infants received L. acidophilus/B. infantis prophylactically for the prevention of necrotizing enterocolitis (NEC). Probiotic use was associated with improved growth measures in the HM group (e.g., weight gain velocity in g/day: effect size B = 0.224; 95% CI: 2.82–4.35; p < 0.001) but not in the F group (effect size B = −0.06; 95% CI: −3.05–0.28; p = 0.103). The HM group had the lowest incidence of clinical sepsis (34.0%) as compared to the Mix group (35.5%) and the F group (40.0%). Only in the Mix group, probiotic supplementation proved to be protective against clinical sepsis (OR 0.69; 95% CI: 0.59–0.79; p < 0.001). Conclusion: Our observational data indicate that the exposure to L. acidophilus/B. infantis probiotics may promote growth in exclusively HM-fed infants as compared to formula-fed infants. To exert a sepsis-preventive effect, probiotics seem to require human milk.

AB - Objective: To evaluate the nutrition-related effects of prophylactic Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on the outcomes of preterm infants <29 weeks of gestation that receive human milk and/or formula nutrition. We hypothesize that human-milk-fed infants benefit from probiotics in terms of sepsis prevention and growth. Methods: We performed an observational study of the German Neonatal Network (GNN) over a period of six years, between 1 January, 2013 and 31 December, 2018. Prophylactic probiotic use of L. acidophilus/B. infantis was evaluated in preterm infants <29 weeks of gestation (n = 7516) in subgroups stratified to feeding type: (I) Exclusively human milk (HM) of own mother and/or donors (HM group, n = 1568), (II) HM of own mother and/or donor and formula (Mix group, n = 5221), and (III) exclusive exposure to formula (F group, n = 727). The effect of probiotics on general outcomes and growth was tested in univariate models and adjusted in linear/logistic regression models. Results: 5954 (76.5%) infants received L. acidophilus/B. infantis prophylactically for the prevention of necrotizing enterocolitis (NEC). Probiotic use was associated with improved growth measures in the HM group (e.g., weight gain velocity in g/day: effect size B = 0.224; 95% CI: 2.82–4.35; p < 0.001) but not in the F group (effect size B = −0.06; 95% CI: −3.05–0.28; p = 0.103). The HM group had the lowest incidence of clinical sepsis (34.0%) as compared to the Mix group (35.5%) and the F group (40.0%). Only in the Mix group, probiotic supplementation proved to be protective against clinical sepsis (OR 0.69; 95% CI: 0.59–0.79; p < 0.001). Conclusion: Our observational data indicate that the exposure to L. acidophilus/B. infantis probiotics may promote growth in exclusively HM-fed infants as compared to formula-fed infants. To exert a sepsis-preventive effect, probiotics seem to require human milk.

UR - https://www.scopus.com/pages/publications/85082464960

UR - https://www.mendeley.com/catalogue/af931ed2-6fdc-3f1f-85c6-c7599c732733/

U2 - 10.3390/nu12030850

DO - 10.3390/nu12030850

M3 - Journal articles

C2 - 32235769

AN - SCOPUS:85082464960

SN - 2072-6643

VL - 12

JO - Nutrients

JF - Nutrients

IS - 3

M1 - 850

ER -

Lactobacillus acidophilus/bifidobacterium infantis probiotics are beneficial to extremely low gestational age infants fed human milk

Abstract

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