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 - http://www.scopus.com/inward/record.url?scp=85082464960&partnerID=8YFLogxK
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 -
