Role of Probiotic Use in Outcomes of Premature Birth

Summary

Project Summary:

The prevalence of preterm birth ranges from 5% to 18% across 184 countries, and an estimated 15 million infants are born preterm globally. These infants with an immature immune system and gastrointestinal tract are at risk of complications of premature birth, which is the leading cause of neonatal death. According to researcher hypothesis for this study, there is role of probiotics in promoting food tolerance and reducing the incidence and severity of Necrotizing Enterocolitis (NEC) and death related to NEC in pre-term VLBW infants. In the current study, we will examine the effects of probiotics in premature infants and figure out the optimal intervention through randomized controlled trial (RCT).

A prospective, masked, randomized single blinded controlled trial will be conducted in the neonatal intensive care unit (NICU) of Services Hospital Lahore. In this trial the treatment group will receive the probiotics during their first month of life, and the control group will receive no treatment. Primary outcome will be the incidence of death or NEC (≥ stage 2). Death is included as a primary outcome because it is a competing variable of NEC. The x2 test will be used to analyze the categorical data, along with Fisher's exact test when applicable. The Student's t test will be used for continuous data. A logistic regression model will be used to analyze the treatment effects on the primary and secondary outcome variables (death, NEC, and sepsis). Values will be expressed for mean and standard deviation. Statistical significance is set at P-value of 0.05.

The objective of this study is to confirm the evidence and to get the more reliable and authentic results regarding the more effective treatment of NEC in preterm neonates. In this way, the researcher shall be able to improve the outcome of premature births and to reduce the complications by increasing the cure rate. Similarly, it will help the researcher to improve knowledge for better management of NEC in neonates.

Conditions

• Necrotizing Enterocolitis of Newborn

Interventions

BIOLOGICAL

probiotic

Probiotic or placebo administration will be started from the first feed of the infants. Infants in the probiotic group will receive five drops of oil-based suspension containing 1×108 colony-forming units of L reuteri (DSM 17938 Biogaia AB, Stockholm, Sweden) once a day, until death or discharge from the hospital. For infants on oral feeds, after suctioning oral secretions, five drops will be placed in the posterior oropharynx of the infants. For infants without per oral feeds, five drops will be administered through a gastric tube followed by a flash of 0.5 mL of sterile water. For the infants in the placebo group, five drops from an identical vial containing only oil base will be administered following the same protocol as the probiotic group.

OTHER

placebo

Probiotic or placebo administration will be started from the first feed of the infants. Infants in the probiotic group will receive five drops of oil-based suspension containing 1×108 colony-forming units of L reuteri (DSM 17938 Biogaia AB, Stockholm, Sweden) once a day, until death or discharge from the hospital. For infants on oral feeds, after suctioning oral secretions, five drops will be placed in the posterior oropharynx of the infants. For infants without per oral feeds, five drops will be administered through a gastric tube followed by a flash of 0.5 mL of sterile water. For the infants in the placebo group, five drops from an identical vial containing only oil base will be administered following the same protocol as the probiotic group.

Sponsors & Collaborators

• Services Institute of Medical Sciences, Pakistan

  collaborator OTHER_GOV

• University of Health Sciences Lahore

  lead OTHER

Principal Investigators

• komal khadim hussain, MBBS · services institute of medical sciences, Lahore

• dr azhar farooq, MBBS,FCPS · services institute of medical sciences, Lahore

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

28 Weeks

Max Age

36 Weeks

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2023-02-20

Primary Completion

2023-06-10

Completion

2023-09-10

Countries

• Pakistan

Study Locations