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The availability of probiotics and donor human milk is associated with improved survival in very preterm infants.
World J Pediatr. 2018 Oct; 14(5):492-497.WJ

Abstract

BACKGROUND

To determine whether the introduction of pasteurized donor human milk and probiotics for infants born < 32 weeks gestational age or < 1500 g birthweight is associated with a reduction in mortality and the incidence of necrotising enterocolitis (NEC) and sepsis.

METHODS

We performed a retrospective analysis of two cohorts: before and after the introduction of probiotics and pasteurised donor human milk. Univariate analysis of primary and secondary outcomes was performed; variables impacting outcomes were assessed using multivariate logistic regression.

RESULTS

There were 1791 infants: 1334 in the pre-donor milk/probiotic cohort and 457 in the post-donor milk/probiotic cohort. On univariate analysis, mortality (7.6 vs. 2.4%, P < 0.001) and incidence of sepsis (6.2 vs. 3.5%, P = 0.028) were statistically significantly lower in the post-donor milk/probiotic group. NEC (2.8 vs. 1.5%, P = 0.14) and non-NEC associated gastrointestinal perforation (1.6 vs. 0.4%, P = 0.052) were lower in the post-donor milk/probiotics cohort, but these were not statistically significant. The difference in mortality remained statistically significant on multivariate analysis in the post-donor milk/probiotic cohort compared to those in the pre-donor milk/probiotic cohort (odds ratio 0.31, 95% confidence interval 0.16-0.61). The decrease in the incidence of NEC was consistent with previous observational studies but the difference was not statistically significant.

CONCLUSION

The availability of probiotics and pasteurised donor human milk is associated with a reduction in mortality in very preterm infants.

Authors+Show Affiliations

Grantley Stable Neonatal Unit, Department of Neonatology, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Brisbane, QLD, 4029, Australia.Queensland Institute of Medical Research and Royal Brisbane and Women's Hospital Statistical Unit, Brisbane, QLD, Australia.Grantley Stable Neonatal Unit, Department of Neonatology, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Brisbane, QLD, 4029, Australia.Grantley Stable Neonatal Unit, Department of Neonatology, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Brisbane, QLD, 4029, Australia. mark.davies@health.qld.gov.au. Department of Pediatrics and Child Health, The University of Queensland, Brisbane, QLD, Australia. mark.davies@health.qld.gov.au.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29951973

Citation

Sharpe, Janet, et al. "The Availability of Probiotics and Donor Human Milk Is Associated With Improved Survival in Very Preterm Infants." World Journal of Pediatrics : WJP, vol. 14, no. 5, 2018, pp. 492-497.
Sharpe J, Way M, Koorts PJ, et al. The availability of probiotics and donor human milk is associated with improved survival in very preterm infants. World J Pediatr. 2018;14(5):492-497.
Sharpe, J., Way, M., Koorts, P. J., & Davies, M. W. (2018). The availability of probiotics and donor human milk is associated with improved survival in very preterm infants. World Journal of Pediatrics : WJP, 14(5), 492-497. https://doi.org/10.1007/s12519-018-0168-0
Sharpe J, et al. The Availability of Probiotics and Donor Human Milk Is Associated With Improved Survival in Very Preterm Infants. World J Pediatr. 2018;14(5):492-497. PubMed PMID: 29951973.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The availability of probiotics and donor human milk is associated with improved survival in very preterm infants. AU - Sharpe,Janet, AU - Way,Mandy, AU - Koorts,Pieter J, AU - Davies,Mark W, Y1 - 2018/06/27/ PY - 2018/01/17/received PY - 2018/05/29/accepted PY - 2018/6/29/pubmed PY - 2019/2/15/medline PY - 2018/6/29/entrez KW - Enterocolitis, necrotizing KW - Infant, newborn KW - Milk banks KW - Milk, human KW - Probiotics SP - 492 EP - 497 JF - World journal of pediatrics : WJP JO - World J Pediatr VL - 14 IS - 5 N2 - BACKGROUND: To determine whether the introduction of pasteurized donor human milk and probiotics for infants born < 32 weeks gestational age or < 1500 g birthweight is associated with a reduction in mortality and the incidence of necrotising enterocolitis (NEC) and sepsis. METHODS: We performed a retrospective analysis of two cohorts: before and after the introduction of probiotics and pasteurised donor human milk. Univariate analysis of primary and secondary outcomes was performed; variables impacting outcomes were assessed using multivariate logistic regression. RESULTS: There were 1791 infants: 1334 in the pre-donor milk/probiotic cohort and 457 in the post-donor milk/probiotic cohort. On univariate analysis, mortality (7.6 vs. 2.4%, P < 0.001) and incidence of sepsis (6.2 vs. 3.5%, P = 0.028) were statistically significantly lower in the post-donor milk/probiotic group. NEC (2.8 vs. 1.5%, P = 0.14) and non-NEC associated gastrointestinal perforation (1.6 vs. 0.4%, P = 0.052) were lower in the post-donor milk/probiotics cohort, but these were not statistically significant. The difference in mortality remained statistically significant on multivariate analysis in the post-donor milk/probiotic cohort compared to those in the pre-donor milk/probiotic cohort (odds ratio 0.31, 95% confidence interval 0.16-0.61). The decrease in the incidence of NEC was consistent with previous observational studies but the difference was not statistically significant. CONCLUSION: The availability of probiotics and pasteurised donor human milk is associated with a reduction in mortality in very preterm infants. SN - 1867-0687 UR - https://www.unboundmedicine.com/medline/citation/29951973/The_availability_of_probiotics_and_donor_human_milk_is_associated_with_improved_survival_in_very_preterm_infants_ L2 - https://dx.doi.org/10.1007/s12519-018-0168-0 DB - PRIME DP - Unbound Medicine ER -