Comparison of The Frequency of Necrotizing Enterocolitis with or Without Probiotics Use in Preterm Neonates
DOI:
https://doi.org/10.70749/ijbr.v3i4.1875Keywords:
Necrotizing Enterocolitis, Probiotics, Bacillus Clausii, Preterm Neonates.Abstract
Background: Necrotizing enterocolitis (NEC) is a gastrointestinal tract medical emergency among premature neonates, notoriously inducing severe morbidity as well as death. Preventive strategies have a central role, particularly in low-income nations. Despite potential with using probiotics in reducing NEC frequency, benefit in selective groups and settings is under researched. Objective: To compare the frequency of necrotizing enterocolitis with or without probiotics use in preterm neonates. Study Design: Randomized controlled trial. Duration and Place of Study: The study was conducted from August 2024 to January 2025 at the Department of Obstetrics and Gynecology, CMH Rawalakot. Methodology: A total of 128 preterm neonates (<37 weeks gestation and <1500 g birth weight) were randomly assigned to two equal groups. Group A received oral Bacillus clausii every 8 hours for 14 days, while Group B received a placebo. NEC was diagnosed based on clinical and radiological findings. Results: Group A showed significantly lower NEC incidence (1.6%) compared to Group B (17.2%) (p=0.003). Stratified analysis revealed consistent protective effects across various subgroups, with a particularly significant reduction among male neonates (2.4% vs. 21.6%, p=0.029). Conclusion: Probiotic supplementation with Bacillus clausii markedly reduces the incidence of necrotizing enterocolitis in preterm neonates.
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1. Lee, A. C., Katz, J., Blencowe, H., Cousens, S., Kozuki, N., Vogel, J. P., Adair, L., Baqui, A. H., Bhutta, Z. A., Caulfield, L. E., Christian, P., Clarke, S. E., Ezzati, M., Fawzi, W., Gonzalez, R., Huybregts, L., Kariuki, S., Kolsteren, P., Lusingu, J., … Black, R. E. (2013). National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. The Lancet Global Health, 1(1), e26-e36.
https://doi.org/10.1016/s2214-109x(13)70006-8
2. Indrio, F., Neu, J., Pettoello-Mantovani, M., Marchese, F., Martini, S., Salatto, A., & Aceti, A. (2022). Development of the gastrointestinal tract in newborns as a challenge for an appropriate nutrition: A narrative review. Nutrients, 14(7), 1405.
https://doi.org/10.3390/nu14071405
3. Chen, C., Lai, M., Lee, C., & Chiang, M. (2025). Nutritional management for preterm infants with common comorbidities: A narrative review. Nutrients, 17(12), 1959.
https://doi.org/10.3390/nu17121959
4. Blanchetière, A., Dolladille, C., Goyer, I., Join-Lambert, O., & Fazilleau, L. (2023). State of the art of probiotic use in neonatal intensive care units in French-speaking European countries. Children, 10(12), 1889.
https://doi.org/10.3390/children10121889
5. Gul, S., & Durante-Mangoni, E. (2024). Unraveling the puzzle: Health benefits of probiotics—A comprehensive review. Journal of Clinical Medicine, 13(5), 1436.
https://doi.org/10.3390/jcm13051436
6. Iqbal, Z., Ahmed, S., Tabassum, N., Bhattacharya, R., & Bose, D. (2021). Role of probiotics in prevention and treatment of enteric infections: A comprehensive review. 3 Biotech, 11(5).
https://doi.org/10.1007/s13205-021-02796-7
7. Monzon, N., Kasahara, E. M., Gunasekaran, A., Burge, K. Y., & Chaaban, H. (2023). Impact of neonatal nutrition on necrotizing enterocolitis. Seminars in Pediatric Surgery, 32(3), 151305.
https://doi.org/10.1016/j.sempedsurg.2023.151305
8. Lin, Y. C., Salleb-Aouissi, A., & Hooven, T. A. (2022). Interpretable prediction of necrotizing enterocolitis from machine learning analysis of premature infant stool microbiota. BMC Bioinformatics, 23(1).
https://doi.org/10.1186/s12859-022-04618-w
9. Shlomai, N. O., Tayeb, M., Omar, R. A., & Friedman, S. E. (2025). Changes in the incidence and severity of NEC over the last decade: A single-center study. Journal of Clinical Medicine, 14(10), 3551.
https://doi.org/10.3390/jcm14103551
10. Hu, X., Liang, H., Li, F., Zhang, R., Zhu, Y., Zhu, X., & Xu, Y. (2024). Necrotizing enterocolitis: Current understanding of the prevention and management. Pediatric Surgery International, 40(1).
https://doi.org/10.1007/s00383-023-05619-3
11. Sowden, M., Van Weissenbruch, M. M., Bulabula, A. N., Van Wyk, L., Twisk, J., & van Niekerk, E. (2022). Effect of a multi-strain probiotic on the incidence and severity of necrotizing Enterocolitis and feeding intolerances in preterm neonates. Nutrients, 14(16), 3305.
https://doi.org/10.3390/nu14163305
12. Dai, Y., Yu, Q., Zhang, F., Ma, K., Yan, X., Chen, W., Chen, X., Li, S., & Han, S. (2025). Effect of probiotics on necrotizing enterocolitis in preterm infants: A network meta-analysis of randomized controlled trials. BMC Pediatrics, 25(1).
https://doi.org/10.1186/s12887-025-05469-z
13. Merenstein, D., Pot, B., Leyer, G., Ouwehand, A. C., Preidis, G. A., Elkins, C. A., Hill, C., Lewis, Z. T., Shane, A. L., Zmora, N., Petrova, M. I., Collado, M. C., Morelli, L., Montoya, G. A., Szajewska, H., Tancredi, D. J., & Sanders, M. E. (2023). Emerging issues in probiotic safety: 2023 perspectives. Gut Microbes, 15(1).
https://doi.org/10.1080/19490976.2023.2185034
14. Arora, S., Khurana, M. S., & Saini, R. (2017). To study the role of probiotics in the prevention of necrotizing enterocolitis in preterm neonates. International Journal of Contemporary Pediatrics, 4(5), 1792.
https://doi.org/10.18203/2349-3291.ijcp20173787
15. Ahmad, W, Sultan, A, N, Younas, I, Ali, M, Naveed, M, Safdar, M, B. (2020). Frequency of necrotizing enterocolitis in preterm infants treated with prophylactic probiotics versus controls. Pak J Med Health Sci 14(3), 929-31.
https://pjmhsonline.com/2020/july-sep/929.pdf
16. Pan, Y., Hou, A., Xue, X., & Fu, J. (2019). The role of probiotics in preventing necrotizing enterocolitis and reducing mortality in neonates: A meta-analysis.
https://doi.org/10.21203/rs.2.13872/v1
17. Hussain, M. U. H. A. M. M. A. D., Jabeen, S., & Subhani, R. U. H. (2016). Role of probiotics in prevention of nectrotizing enterocolitis in preterm low birth weight neonates. Pak J Med Health Sci, 10(2), 455-457.
18. Chowdhury, T., Ali, M. M., Hossain, M. M., Singh, J., Yousuf, A. N., Yasmin, F., & Chowdhury, F. R. (2016). Efficacy of probiotics versus placebo in the prevention of necrotizing enterocolitis in preterm very low birth weight infants: a double-blind randomized controlled trial. J Coll Physicians Surg Pak, 26(9), 770-774.
https://www.jcpsp.pk/archive/2016/Sep2016/11.pdf
19. Khan, Z., Shahid, G., Riaz, I. H. S. S., & Gul, S. S. (2016). Comparison of probiotics versus zinc in the prevention of necrotizing enterocolitis in preterm neonates. Annals of PIMS ISSN, 1815, 2287.
20. Patole, S. K., Rao, S. C., Keil, A. D., Nathan, E. A., Doherty, D. A., & Simmer, K. N. (2016). Benefits of Bifidobacterium breve M-16V supplementation in preterm neonates - A retrospective cohort study. PLOS ONE, 11(3), e0150775.
https://doi.org/10.1371/journal.pone.0150775
21. More, K., Hanumantharaju, A., Amrit, A., Nimbalkar, S. M., & Patole, S. (2024). Use of probiotics for preventing necrotizing Enterocolitis in preterm infants: A survey of current practices among Indian Neonatologists. Cureus.
https://doi.org/10.7759/cureus.73923
22. Deshpande, G., & Patole, S. (2010). Probiotic for preventing necrotising enterocolitis in preterm neonates-The past, present, and the future. Eastern Journal of Medicine, 15(4), 168.
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