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Probiotic Use and Safety in the Neonatal Intensive Care Unit: A Matched Cohort Study.

Publication ,  Journal Article
Gray, KD; Messina, JA; Cortina, C; Owens, T; Fowler, M; Foster, M; Gbadegesin, S; Clark, RH; Benjamin, DK; Zimmerman, KO; Greenberg, RG
Published in: J Pediatr
July 2020

OBJECTIVE: To determine the prevalence of probiotic administration in infants born preterm over time, as well as the association between probiotic administration and select adverse outcomes. STUDY DESIGN: We performed a multicenter cohort study of infants 23-29 weeks of gestational age admitted to 289 neonatal intensive care units from 1997 to 2016. We evaluated the type of probiotics given and prevalence of exposure to probiotics over time and by site. We matched infants exposed to probiotics by several factors to unexposed infants receiving enteral feeds on the same postnatal day. We performed conditional logistic regression to evaluate the association between probiotics exposure and adverse outcomes, including necrotizing enterocolitis (NEC), bloodstream infections, meningitis, and death. RESULTS: Of 78 076 infants, 3626 (4.6%) received probiotics. Probiotic use increased over the study period and varied among neonatal intensive care units. We matched 2178 infants exposed to probiotics to 33 807 without exposure. Probiotic administration was associated with a decrease in NEC (OR 0.62, 95% CI 0.48-0.80) and death (OR 0.52, 95% CI 0.39-0.70), an increase in Candida infection (OR 2.23, 95% CI 1.29-3.85), but no increase in bloodstream infection (OR 0.86, 95% CI 0.70-1.05) or meningitis (OR 1.18, 95% CI 0.40-3.46). CONCLUSIONS: Probiotic use increased over time and was associated with decreased odds of NEC and death. Prospective, randomized-controlled studies of specific probiotic products are needed to further investigate the safety and efficacy of probiotics in preterm infants.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

July 2020

Volume

222

Start / End Page

59 / 64.e1

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Probiotics
  • Pediatrics
  • Male
  • Intensive Care Units, Neonatal
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant
  • Humans
  • Female
 

Citation

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Chicago
ICMJE
MLA
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Gray, K. D., Messina, J. A., Cortina, C., Owens, T., Fowler, M., Foster, M., … Greenberg, R. G. (2020). Probiotic Use and Safety in the Neonatal Intensive Care Unit: A Matched Cohort Study. J Pediatr, 222, 59-64.e1. https://doi.org/10.1016/j.jpeds.2020.03.051
Gray, Keyaria D., Julia A. Messina, Christopher Cortina, Tanasha Owens, Madeline Fowler, Matthew Foster, Simi Gbadegesin, et al. “Probiotic Use and Safety in the Neonatal Intensive Care Unit: A Matched Cohort Study.J Pediatr 222 (July 2020): 59-64.e1. https://doi.org/10.1016/j.jpeds.2020.03.051.
Gray KD, Messina JA, Cortina C, Owens T, Fowler M, Foster M, et al. Probiotic Use and Safety in the Neonatal Intensive Care Unit: A Matched Cohort Study. J Pediatr. 2020 Jul;222:59-64.e1.
Gray, Keyaria D., et al. “Probiotic Use and Safety in the Neonatal Intensive Care Unit: A Matched Cohort Study.J Pediatr, vol. 222, July 2020, pp. 59-64.e1. Pubmed, doi:10.1016/j.jpeds.2020.03.051.
Gray KD, Messina JA, Cortina C, Owens T, Fowler M, Foster M, Gbadegesin S, Clark RH, Benjamin DK, Zimmerman KO, Greenberg RG. Probiotic Use and Safety in the Neonatal Intensive Care Unit: A Matched Cohort Study. J Pediatr. 2020 Jul;222:59-64.e1.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

July 2020

Volume

222

Start / End Page

59 / 64.e1

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Probiotics
  • Pediatrics
  • Male
  • Intensive Care Units, Neonatal
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant
  • Humans
  • Female