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Neutral and acidic oligosaccharides in preterm infants: a randomized, double-blind, placebo-controlled trial.
Am J Clin Nutr. 2010 Mar; 91(3):679-86.AJ

Abstract

BACKGROUND

Serious infectious morbidity is high in preterm infants. Enteral supplementation of prebiotics may reduce the incidence of serious infections, especially infections related to the gastrointestinal tract.

OBJECTIVE

The objective was to determine the effect of enteral supplementation of a prebiotic mixture consisting of neutral oligosaccharides ((SC)GOS/(LC)FOS) and acidic oligosaccharides (AOS) on serious infectious morbidity in preterm infants.

DESIGN

In a randomized controlled trial, preterm infants (gestational age <32 wk and/or birth weight <1500 g) received enteral supplementation of 80% (SC)GOS/(LC)FOS and 20% AOS (1.5 g . kg(-1) . d(-1)) or placebo (maltodextrin) between days 3 and 30 of life. Serious infectious morbidity was defined as a culture positive for sepsis, meningitis, pyelonephritis, or pneumonia. The analysis was performed by intention-to-treat and per-protocol, defined as > or =50% supplementation dose during the study period.

RESULTS

In total, 113 preterm infants were included. Baseline and nutritional characteristics were not different between groups. In the intention-to-treat analysis, the incidence of > or =1 serious infection, > or =1 serious endogenous infection, or > or =2 serious infectious episodes was not significantly different in the (SC)GOS/(LC)FOS/AOS-supplemented and placebo groups. In the per-protocol analysis, there was a trend toward a lower incidence of > or =1 serious endogenous infection and > or =2 serious infectious episodes in the (SC)GOS/(LC)FOS/AOS-supplemented group than in the placebo group (P = 0.09 and P = 0.07, respectively).

CONCLUSIONS

Enteral supplementation of (SC)GOS/(LC)FOS/AOS does not significantly reduce the risk of serious infectious morbidity in preterm infants. However, there was a trend toward a lower incidence of serious infectious morbidity, especially for infections with endogenous bacteria. This finding suggests a possible beneficial effect that should be evaluated in a larger study. This trial was registered at isrctn.org as ISRCTN16211826.

Authors+Show Affiliations

Department of Pediatrics, VU University Medical Center, Amsterdam, Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20032496

Citation

Westerbeek, Elisabeth Am, et al. "Neutral and Acidic Oligosaccharides in Preterm Infants: a Randomized, Double-blind, Placebo-controlled Trial." The American Journal of Clinical Nutrition, vol. 91, no. 3, 2010, pp. 679-86.
Westerbeek EA, van den Berg JP, Lafeber HN, et al. Neutral and acidic oligosaccharides in preterm infants: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2010;91(3):679-86.
Westerbeek, E. A., van den Berg, J. P., Lafeber, H. N., Fetter, W. P., Boehm, G., Twisk, J. W., & van Elburg, R. M. (2010). Neutral and acidic oligosaccharides in preterm infants: a randomized, double-blind, placebo-controlled trial. The American Journal of Clinical Nutrition, 91(3), 679-86. https://doi.org/10.3945/ajcn.2009.28625
Westerbeek EA, et al. Neutral and Acidic Oligosaccharides in Preterm Infants: a Randomized, Double-blind, Placebo-controlled Trial. Am J Clin Nutr. 2010;91(3):679-86. PubMed PMID: 20032496.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neutral and acidic oligosaccharides in preterm infants: a randomized, double-blind, placebo-controlled trial. AU - Westerbeek,Elisabeth Am, AU - van den Berg,Jolice P, AU - Lafeber,Harrie N, AU - Fetter,Willem Pf, AU - Boehm,Guenther, AU - Twisk,Jos Wr, AU - van Elburg,Ruurd M, Y1 - 2009/12/23/ PY - 2009/12/25/entrez PY - 2009/12/25/pubmed PY - 2010/3/31/medline SP - 679 EP - 86 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 91 IS - 3 N2 - BACKGROUND: Serious infectious morbidity is high in preterm infants. Enteral supplementation of prebiotics may reduce the incidence of serious infections, especially infections related to the gastrointestinal tract. OBJECTIVE: The objective was to determine the effect of enteral supplementation of a prebiotic mixture consisting of neutral oligosaccharides ((SC)GOS/(LC)FOS) and acidic oligosaccharides (AOS) on serious infectious morbidity in preterm infants. DESIGN: In a randomized controlled trial, preterm infants (gestational age <32 wk and/or birth weight <1500 g) received enteral supplementation of 80% (SC)GOS/(LC)FOS and 20% AOS (1.5 g . kg(-1) . d(-1)) or placebo (maltodextrin) between days 3 and 30 of life. Serious infectious morbidity was defined as a culture positive for sepsis, meningitis, pyelonephritis, or pneumonia. The analysis was performed by intention-to-treat and per-protocol, defined as > or =50% supplementation dose during the study period. RESULTS: In total, 113 preterm infants were included. Baseline and nutritional characteristics were not different between groups. In the intention-to-treat analysis, the incidence of > or =1 serious infection, > or =1 serious endogenous infection, or > or =2 serious infectious episodes was not significantly different in the (SC)GOS/(LC)FOS/AOS-supplemented and placebo groups. In the per-protocol analysis, there was a trend toward a lower incidence of > or =1 serious endogenous infection and > or =2 serious infectious episodes in the (SC)GOS/(LC)FOS/AOS-supplemented group than in the placebo group (P = 0.09 and P = 0.07, respectively). CONCLUSIONS: Enteral supplementation of (SC)GOS/(LC)FOS/AOS does not significantly reduce the risk of serious infectious morbidity in preterm infants. However, there was a trend toward a lower incidence of serious infectious morbidity, especially for infections with endogenous bacteria. This finding suggests a possible beneficial effect that should be evaluated in a larger study. This trial was registered at isrctn.org as ISRCTN16211826. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/20032496/Neutral_and_acidic_oligosaccharides_in_preterm_infants:_a_randomized_double_blind_placebo_controlled_trial_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2009.28625 DB - PRIME DP - Unbound Medicine ER -