Probiotics are live non-pathogenic micro-organisms administered to improve microbial balance particularly in the gastrointestinal tract. Probiotics can decrease colonization and invasion of pathogenic bacteria that can be life-threatening to the host. Probiotics may offer benefit to the immature system and gastrointestinal tract of the premature neonate. We hypothesized that the risk for complications of premature birth and the need for parenteral nutrition will be lower in babies receiving probiotics compared to not receiving probiotics.

We examined premature babies born less than 33 weeks from September 2014 through March 2015 who received probiotics compared to babies who did not receive probiotics born between February 2014 and August 2014. The outcomes examined were complications of premature birth, including BPD, ROP, IVH, PDA, NEC, and Sepsis, totals days on total parenteral nutrition (TPN), number of blood cultures, number of lumbar punctures, number of urine tests, and weight at 30, 34, and 36 weeks. Linear and logistic regressions were performed with each outcome adjusting for birth weight. Birth weight and gestational age were lower in the group of infants that received probiotics compared to those who did not. After adjusting for birth weight, probiotics were protective against BPD (OR=0.499) and sepsis (OR=0.37). However, infants on probiotics received more lumbar punctures (1 or more) than those who did not receive probiotics.

In our population, probiotics significantly reduced the risk for sepsis and had a modest benefit on BPD risk. This study supports the benefits of probiotics in the NICU. Hospitals and clinics across the nation should consider probiotics as a potential intervention in premature babies for reducing the risk of sepsis, and potentially BPD.