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Probiotics for preterm infants: A National Retrospective Cohort Study



To evaluate the effect of prophylactic probiotic (PP) administration on rates of necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and mortality in preterm infants.

Study design

We conducted a retrospective cohort study of infants < 29 weeks’ gestation, admitted to neonatal intensive care units participating in the Canadian Neonatal Network between 1 January 2014 and 31 December 2015. Infants in the exposure group received PP. A multiple logistic regression model with generalized estimation equation was used.


A total of 3093 infants were included, 652 infants (21%) received PP. The adjusted odds ratios (aOR) of NEC (aOR 0.64, 95% confidence interval [CI] 0.410, 0.996), mortality (aOR 0.41, 95% CI 0.26, 0.63), and a composite of NEC or mortality were significantly lower in the PP group. There was no significant difference in the aOR of LOS.


Prophylactic probiotic administration is associated with a reduction in NEC and mortality in preterm infants.

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We gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network (CNN). We also thank the staff at the Maternal-Infant Care (MICare) Research Center at Mount Sinai Hospital, Toronto, ON for organizational support of CNN. In addition, we thank Xiang Y Ye, MSc for statistical support and Sarah Hutchinson, Ph.D for editorial assistance in the preparation of this manuscript. MICare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and in-kind support from Mount Sinai Hospital.

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Correspondence to Balpreet Singh.

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The authors declare that they have no conflict of interest.

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A full list of Canadian Neonatal Network Site Investigators can be found in the Supplementary Information

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Singh, B., Shah, P.S., Afifi, J. et al. Probiotics for preterm infants: A National Retrospective Cohort Study. J Perinatol 39, 533–539 (2019).

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