by Elana Gotkine

Probiotics linked to reduced mortality in infants born before 34 weeks

For infants born before 34 weeks of gestation and with a birth weight <1,000 g, probiotics used in neonatal units are associated with reduced mortality, according to a study published online Feb. 12 in Pediatrics.

Belal N. Alshaikh, M.D., M.P.H., from the University of Calgary Cumming School of Medicine in Alberta, Canada, and colleagues conducted a retrospective cohort study involving infants born before 34 weeks of gestation and admitted to 33 Canadian Neonatal Network units from Jan. 1, 2016, to Dec. 31, 2022. The effectiveness and risks for probiotics were examined among infants born before 34 weeks of gestation and with a birth weight <1,000 g.

The researchers found that 57.5 and 42.5% of the 32,667 eligible infants received probiotics and did not receive probiotics, respectively. Probiotics were associated with reduced mortality rates (adjusted odds ratio [aOR], 0.62; 98.3% confidence interval [CI], 0.53 to 0.73), but not with reduced rates of necrotizing enterocolitis (aOR, 0.92; 98.3% CI, 0.78 to 1.09) or late-onset sepsis (aOR, 0.90; 98.3% CI, 0.80 to 1.01).

Probiotics were associated with reduced mortality rates in the 7,401 infants with a birth weight <1,000 g (aOR, 0.58; 98.3% CI, 0.47 to 0.71), but not with decreased rates of necrotizing enterocolitis (aOR, 0.90; 98.3% CI, 0.71 to 1.13) or late-onset sepsis (aOR, 1.01; 98.3% CI, 0.86 to 1.18). In 27 and 20 infants born before 34 weeks of gestation and with a birth weight <1,000 g, probiotic sepsis occurred (1.4 and 4.0 per 1,000, respectively). Three infants with probiotic sepsis died; in two cases, probiotic sepsis was deemed a possible cause.

"Our findings can help health care providers counsel parents on the benefits and risks of probiotics," the authors write.

More information: Belal N. Alshaikh et al, Effectiveness and Risks of Probiotics in Preterm Infants, Pediatrics (2025). DOI: 10.1542/peds.2024-069102

Roger F. Soll et al, Safety and Efficacy of Probiotics for Preterm Infants, Pediatrics (2025). DOI: 10.1542/peds.2024-069450

Journal information: Pediatrics 

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