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Standardized feeding and probiotic supplementation for reducing necrotizing enterocolitis in preterm infants in a resource limited set up

European Journal of Clinical Nutrition volume 72, pages 281–287 (2018)Cite this article

Subjects

Abstract

Background/objectives

Necrotizing enterocolitis (NEC ≥ Stage II) is associated with high mortality and morbidity in preterm infants. To assess if introduction of standardized feeding regimen (SFR) and routine probiotic supplementation (RPS) was associated with reduced incidence of NEC in preterm infants in our nursery in a resource limited set up.

Subjects/methods

This was a retrospective cohort study assessing the incidence of NEC ≥ Stage II before (Epoch 1: N = 144) vs. after (Epoch 2, N = 144) implementation of SFR and RPS in preterm infants < 35 weeks.

Results

The median (IQR) gestation and birth weight in epoch 1 and epoch 2 was [32 (30, 33.5) vs. 31.5 (30, 34) weeks, p = 0.829], and [1350 (1100, 1700) vs. 1370 (1110, 1550) g, p = 0.363] respectively. Both groups had predominantly outborn infants (Epoch 1: 79.2% vs. Epoch 2: 78.2%; p = 1.00). Multivariate analysis after adjusting for potential confounders found a significantly lower incidence of NEC ≥ Stage II after implementing SFR and RPS (Epoch 1: 17.4% vs. Epoch 2:9.0%, adjusted odds ratio aOR: 0.19; 95% CI: 0.05, 0.71, p = 0.013). The incidence of the composite outcome of ‘NEC or Mortality’ was also significantly lower after the intervention (Epoch 1: 21.5% vs. Epoch 2: 14.6%; aOR 0.24, 95% CI: 0.07, 0.85, p = 0.027).

Conclusions

Introduction of SFR and RPS was associated with significant reduction in NEC ≥ Stage II and the composite outcome of NEC ≥ Stage II /mortality in preterm infants.

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Acknowledgements

Maharashtra Medical Research Society, Pune.

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Authors and Affiliations

  1. Department of Neonatology, Ratna Memorial Hospital, Pune, India

    Saurabh Patel, Mayur Chaudhari & Sandeep Kadam

  2. Centre for Neonatal Research and Education, University of Western Australia, Perth, Australia

    Shripada Rao & Sanjay Patole

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  1. Saurabh Patel
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Correspondence to Sandeep Kadam.

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Patel, S., Chaudhari, M., Kadam, S. et al. Standardized feeding and probiotic supplementation for reducing necrotizing enterocolitis in preterm infants in a resource limited set up. Eur J Clin Nutr 72, 281–287 (2018). https://doi.org/10.1038/s41430-017-0040-7

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