Benefits of Bifidobacterium breve M-16V Supplementation in Preterm Neonates - A Retrospective Cohort Study.
Benefits of Bifidobacterium breve M-16V Supplementation in Preterm Neonates - A Retrospective Cohort Study.
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DOI：
10.1371/journal.pone.0150775
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Simmer KN
中科院分区：
文献类型：
--
作者：
Patole SK;Rao SC;Keil AD;Nathan EA;Doherty DA;Simmer KN
随机对照试验的系统评价报告，益生菌可降低早产儿坏死性小肠结肠炎（NEC）的风险。目的：确定对早产儿常规补充益生菌（RPS）是否会降低NEC的发生率。在<34周的新生儿使用短双歧杆菌M-16V进行RPS前（Epoch 1）和后（Epoch 2） 24个月的相同时间内，比较NEC≥II期和全因死亡率的发生率。进行多因素logistic回归分析以校正相关混杂因素。共有1755名妊娠期和出生体重相当的新生儿（I期对II期：835对920）被纳入研究。NEC≥II期显著降低：3% vs. 1%，校正优势比(aOR) = 0.43 (95%CI: 0.21-0.87)；“NEC≥II期或全因死亡率”：9%比5%，aOR = 0.53 (95%CI: 0.32-0.88)；但并非全因死亡率：第二期为7% vs. 4%, aOR = 0.58 （95% CI: 0.31-1.06）。新生儿<28周的获益未达到统计学意义：NEC≥II期：6% vs. 3%, aOR 0.51 (95%CI: 0.20-1.27)，“NEC≥II期或全因死亡率”，21% vs. 14%, aOR = 0.59 (95%CI: 0.29-1.18)；全因死亡率：17% vs. 11%, aOR = 0.63 （95%CI: 0.28-1.41）。无益生菌败血症。短双歧杆菌M-16V的RPS与<34周新生儿NEC≥II期和NEC≥II期或全因死亡率降低相关。需要大样本量来评估RPS对<28周新生儿的潜在益处。
Systematic reviews of randomised controlled trials report that probiotics reduce the risk of necrotising enterocolitis (NEC) in preterm neonates. To determine whether routine probiotic supplementation (RPS) to preterm neonates would reduce the incidence of NEC. The incidence of NEC ≥ Stage II and all-cause mortality was compared for an equal period of 24 months ‘before’ (Epoch 1) and ‘after’ (Epoch 2) RPS with Bifidobacterium breve M-16V in neonates <34 weeks. Multivariate logistic regression analysis was conducted to adjust for relevant confounders. A total of 1755 neonates (Epoch I vs. II: 835 vs. 920) with comparable gestation and birth weights were admitted. There was a significant reduction in NEC ≥ Stage II: 3% vs. 1%, adjusted odds ratio (aOR) = 0.43 (95%CI: 0.21–0.87); ‘NEC ≥ Stage II or all-cause mortality’: 9% vs. 5%, aOR = 0.53 (95%CI: 0.32–0.88); but not all-cause mortality alone: 7% vs. 4%, aOR = 0.58 (95% CI: 0.31–1.06) in Epoch II. The benefits in neonates <28 weeks did not reach statistical significance: NEC ≥ Stage II: 6% vs. 3%, aOR 0.51 (95%CI: 0.20–1.27), ‘NEC ≥ Stage II or all-cause mortality’, 21% vs. 14%, aOR = 0.59 (95%CI: 0.29–1.18); all-cause mortality: 17% vs. 11%, aOR = 0.63 (95%CI: 0.28–1.41). There was no probiotic sepsis. RPS with Bifidobacterium breve M-16V was associated with decreased NEC≥ Stage II and ‘NEC≥ Stage II or all-cause mortality’ in neonates <34 weeks. Large sample size is required to assess the potential benefits of RPS in neonates <28 weeks.