Abstract
Background Cholestasis is a common but serious clinical condition in preterm neonates. The current management for preterm neonatal cholestasis has limitations. The aim of this study was to determine effects of Bifidobacterium supplementation on the prevention and alleviation of cholestasis in preterm infants with very low birth weight. Methods Preterm neonates with very low birth weight were enrolled in the Children's Hospital of Soochow University between December 2012 and December 2017. The patients were randomly assigned into Bifidobacterium and control groups, and effects of Bifidobacterium supplementation on the outcomes were compared between the two groups. Results There was no significant difference in the baseline characteristics in the two groups. Notably, the proportion of cases with neonatal cholestasis was significantly lower, with fewer neonatal cholestasis-associated complications in the Bifidobacterium group compared with the control group (6% versus 22%, P < 0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (P < 0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (P < 0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (days, P < 0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (P < 0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (P < 0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (P < 0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (P < 0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (Conclusions Bifidobacterium supplementation has significantly preventive and other beneficial effects on the management of cholestasis in preterm infants with very low birth weight. Its long-term safety and effectiveness will need further investigation. This trial is registered with the Chinese Clinical Trial Registry (Registration No. ChiCTR1900022296).
Highlights
Cholestasis is a common but serious clinical condition in preterm neonates
Ten patients were excluded from this study, including one congenital birth defect, five severe symptoms of digestive diseases before total parenteral nutrition (TPN), and four cholestasis diagnosed at the time of admission
This study of effects of Bifidobacterium supplementation on cholestasis in preterm infants with very low birth weight has the following main novel findings: (1) Bifidobacterium supplementation significantly reduced the risk for neonatal cholestasis and its related complications in the preterm infants with very low birth weight (Table 1); (2) Bifidobacterium supplementation was significantly associated with less severity of neonatal cholestasis and better improvement of the liver function in the preterm infants with very low birth weight (Tables 2 and 3); and (3) Bifidobacterium supplementation significantly shortened the time to reach the full enteral feeding, duration of hospitalization, meconium passage, and duration of weight gain to normal and improved other outcomes in the preterm infants with very low birth weight (Table 4)
Summary
Cholestasis is a common but serious clinical condition in preterm neonates. The current management for preterm neonatal cholestasis has limitations. Prebiotics had impact on the growth of beneficial bacteria in the gut [11, 12], alleviation of the cell damage in the small intestine, reduction of intestinal inflammation, promotion of maturation of the intestinal function, and improvement of the stool frequency and shape, as well as enteral feeding tolerance in preterm infants [13]. It remains to be further investigated for the effect of prebiotic supplementation on the prevention and severity of neonatal cholestasis in preterm neonate with very low birth weight
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