ROLE OF PROBIOTICS IN PREVENTION OF NECROTIZING ENTEROCOLITIS AMONG PRETERM NEONATES.

Abstract

Background; Necrotising enterocolitis (NEC) is the most commonly occurring gastrointestinal emergency in preterm infants. This study was conducted to determine frequency of necrotizing enterocolitis (NEC) in preterm infants less 1.5 Kg taking probiotics at a tertiary care hospital. Material and Methods; Consecutive 270 preterm neonates having weight less than 1.5 Kg was taken in this descriptive case – series study. Once registered, the study cases were fed with Infloran (Lactobacillus acidophilus) and Bifidobacterium infants, 125 mg/kg per dose was given twice daily with breast milk until discharged and were followed for two weeks to see NEC. The amount of feeding was advanced slowly if tolerated, with no more than 20 mL/kg per day increment per day. These study cases were followed for 15 days to record outcome variable i.e. NEC. Data was analyzed by using SPSS Version 20. Results; Of these 270 study cases, 139 (51.5%) were boys while 131 (48.5%) were girls. Mean gestational age of our study cases was 29.61 ± 2.66 weeks (with minimum gestational age was 24 weeks while maximum gestational age was 34 weeks). Of these 270 study cases, 147 belonged to urban areas and most of our study cases i.e. 179 (66.3%) were poor, 79 (29.3%) were from middle income families and only 12 (4.4%) belonged to rich families. Mean weight of our study cases was 1312.85 ± 78.66 grams. Mean maternal age was noted to 27.91 ± 4.24 years, 170 (62.96 %) mothers were less than 30 years of age and most of these mothers were illiterate i.e. 191 (70.7%). Majority of these mothers i.e. 170 (62.96 %) had parity less than 3. Mean duration on probiotics was noted to be 14.88 ± 1.38 days. Necrotizing enterocolitis was noted in 15 (5.6%) of our study cases. Conclusion; Our study results have shown that frequency of necrotizing enterocolitis (NEC) was low in preterm infants using probiotics. The use of probiotics was effective in the prevention of NEC and our study results support the use of probiotics in these infants. Probiotics were found to be safe, reliable and efficacious in our study. NEC was significantly associated with gender, gestational age, residential status, poor socioeconomic status, increasing maternal age and parity and duration on probiotics. Keywords; Probiotics, necrotizing enterocolitis, preterm infants.