scholarly journals The effect of routine probiotics supplementation on preterm newborn health: a regression discontinuity analysis

2020 ◽  
Vol 112 (5) ◽  
pp. 1219-1227 ◽  
Author(s):  
Christian Bommer ◽  
Sebastian Horn ◽  
Sebastian Vollmer
Keyword(s):  
Regression Discontinuity ◽  
Late Onset ◽  
Preterm Neonates ◽  
Preterm Newborn ◽  
Late Onset Sepsis ◽  
Z Scores ◽  
Moderately Preterm ◽  
Preterm Newborns ◽  
Height For Age ◽  
Weight For Age

ABSTRACT Background Despite ongoing debate about the health impact of probiotics, rigorous evidence assessing the use of probiotics in routine preterm newborn care is lacking. Objectives We aimed to estimate the causal effect of routine probiotics supplementation on moderately preterm newborns’ anthropometric development (weight-for-age and height-for-age z scores) and risk of late-onset sepsis. Methods This study used a regression discontinuity analysis based on hospital guidelines that recommended routine probiotics supplementation for neonates born before 34 completed weeks of gestation. Data for this study came from electronic medical records of a level III neonatal care center in Germany and were collected between 2013 and 2019. Newborns born between 30 to 38 completed weeks of gestation without severe congenital defects were eligible for inclusion. Outcomes were weight-for-age and height-for-age z scores at discharge as well as late-onset sepsis. Results Study participants included 1734 preterm neonates. The results showed no significant intention-to-treat effect on weight-for-age (effect: −0.033 SD; 95% CI: −0.220, 0.155), length-for-age (−0.133 SD; 95% CI: −0.380, 0.114), or late-onset sepsis probability (−1.175 percentage points; 95% CI: −6.556, 4.205). There was no evidence for significant effects of probiotics for any of the study's endpoints on those complying with the hospital guidelines (local average treatment effect). Conclusions Routine treatment of moderately preterm newborns with probiotics is unlikely to improve anthropometric outcomes. Complier-level analysis suggested that this finding was not simply driven by a lack of physician compliance with hospital guidelines but by an overall absence of large health effects from the treatment itself. Moreover, overall sepsis risk was low and did not change significantly as a result of probiotics supplementation. The findings of this study therefore do not support the routine use of probiotics for improving growth or preventing late-onset sepsis in moderately preterm neonates.

5ICCN_009: Presepsin for the diagnosis of late-onset sepsis in preterm newborns

2014 ◽  
Vol 90 ◽  
pp. S64-S65
Author(s):  
C. Poggi ◽  
T. Bianconi ◽  
E. Gozzini ◽  
M. Generoso ◽  
C. Dani
Keyword(s):  
Late Onset ◽  
Late Onset Sepsis ◽  
Preterm Newborns

scholarly journals Probiotics to prevent necrotising enterocolitis and nosocomial infection in very low birth weight preterm infants

2017 ◽  
Vol 117 (7) ◽  
pp. 994-1000 ◽  
Author(s):  
J. Uberos ◽  
E. Aguilera-Rodríguez ◽  
A. Jerez-Calero ◽  
M. Molina-Oya ◽  
A. Molina-Carballo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Necrotising Enterocolitis ◽  
Stage Ii ◽  
Preterm Neonates ◽  
Probiotic Supplementation ◽  
Late Onset Sepsis ◽  
Reduced Risk

AbstractThe aim of the study was to determine whether routine probiotic supplementation (RPS) with Lactobacillus rhamnosus GG (LGG) or Lactobacillus acidophilus +Lactobacillus bifidum is associated with reduced risk of necrotising enterocolitis (NEC)≥Stage II in preterm neonates born at ≤32 weeks’ gestation. We conducted a retrospective cohort study on the effect of probiotic supplementation in very low birth weight infants in our neonatal unit by comparing two periods: before and after supplementation. The incidence of NEC≥Stage II, late-onset sepsis and all-cause mortality was compared for an equal period ‘before’ (Period I) and ‘after’ (Period II) RPS with LGG or L. acidophillus+L. bifidum. Multivariate logistic regression analysis was conducted to adjust for relevant confounders. The study population was composed of 261 neonates (Period I v. II: 134 v. 127) with comparable gestation duration and birth weights. In <32 weeks, we observed a significant reduction in NEC≥Stage II (11·3 v. 4·8 %), late-onset sepsis (16 v. 10·5 %) and mortality (19·4 v. 2·3 %). The benefits in neonates aged ≤27 weeks did not reach statistical significance. RPS with LGG or L. acidophillus+L. bifidum is associated with a reduced risk of NEC≥Stage II, late-onset sepsis and mortality in preterm neonates born at ≤32 weeks’ gestation.

Effect of lactoferrin in the prevention of late-onset sepsis in preterm neonates: a randomized-controlled trial

2021 ◽  
Vol 34 (1) ◽  
pp. 1
Author(s):  
MarwaM Farag ◽  
OmneyaM.K.B Eldin ◽  
MennattAllahH Attia ◽  
NadaI.A Morsi ◽  
RaniaM.A.S El haddad
Keyword(s):  
Randomized Controlled Trial ◽  
Late Onset ◽  
Controlled Trial ◽  
Preterm Neonates ◽  
Randomized Controlled ◽  
Late Onset Sepsis

scholarly journals Association of Whole Blood Fatty Acids and Growth in Southern Ghanaian Children 2–6 Years of Age

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 954 ◽  
Author(s):  
Mary Adjepong ◽  
William Yakah ◽  
William Harris ◽  
Esi Colecraft ◽  
Grace Marquis ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Growth Parameters ◽  
Dietary Fatty Acids ◽  
Northern Ghana ◽  
Z Score ◽  
Omega 3 ◽  
Omega 6 ◽  
Z Scores ◽  
Height For Age ◽  
Weight For Age

In Ghana, stunting rates in children below 5 years of age vary regionally. Dietary fatty acids (FAs) are crucial for linear growth. The objective of this study was to determine the association between blood FAs and growth parameters in southern Ghanaian children 2–6 years of age. A drop of blood was collected on an antioxidant treated card and analyzed for FA composition. Weight and height were measured and z-scores calculated. Relationships between FAs and growth were analyzed by linear regressions and factor analysis. Of the 209 subjects, 22% were stunted and 10.6% were essential FA deficient (triene/tetraene ratio > 0.02). Essential FA did not differ between stunted and non-stunted children and was not associated with height-for-age z-score or weight-for-age z-score. Similarly, no relationships between other blood fatty acids and growth parameters were observed in this population. However, when blood fatty acid levels in these children were compared to previously reported values from northern Ghana, the analysis showed that blood omega-3 FA levels were significantly higher and omega-6 FA levels lower in the southern Ghanaian children (p < 0.001). Fish and seafood consumption in this southern cohort was high and could account for the lower stunting rates observed in these children compared to other regions.

scholarly journals Sustained Positive Deviant Child Care Practices and Their Effects on Child Growth in Viet Nam

2002 ◽  
Vol 23 (4_suppl2) ◽  
pp. 16-25 ◽  
Author(s):  
U. Agnes Trinh Mackintosh ◽  
David R. Marsh ◽  
Dirk G. Schroeder
Keyword(s):  
Child Growth ◽  
Program Completion ◽  
Viet Nam ◽  
Nutrition Program ◽  
Cross Sectional ◽  
Total N ◽  
Z Scores ◽  
Growth Promoting ◽  
Height For Age ◽  
Weight For Age

Save the Children's (SC) successful integrated nutrition program in Viet Nam, the poverty alleviation and nutrition program (PANP), uses the positive deviance (PD) approach to identify key growth promoting behaviors and provides participatory adult education allowing mothers to develop skills related to these behaviors. We investigated whether improvements seen during a PANP intervention (1993–1995) were sustained three and four years after SC's departure. Cross-sectional surveys were administered to 46 randomly selected households in four communes that had previously participated in the PANP and 25 households in a neighboring comparison community in 1998 and 1999. Two children per household, an older child who had participated in the PANP and a younger sibling who had not, were measured (total n = 142 children), and their mothers were interviewed. Older SC children tended to be better nourished than their counterparts. Their younger siblings were significantly better nourished than those in the comparison group, with adjusted mean weight-for-age Z scores of −1.82 versus −2.45 ( p = .007), weight-for-height Z scores of −0.71 versus −1.45 ( p < .001), and height-for-age Z scores of −2.11 and −2.37 (ns, p = .4), respectively. SC mothers reporting feeding the younger siblings more than their counterparts did (2.9 versus 2.2 main meals per day, p < .001, and 96.2% versus 52% offering snacks, p < .01]. SC mothers reported washing their hands “often” more than comparison mothers (100% vs. 76%, p < .001). Growth-promoting behaviors identified through PD studies and practiced through neighborhood-based rehabilitation sessions persisted years after program completion. These sustained behaviors contributed to better growth of younger siblings never exposed to the program.

scholarly journals Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores in Nepal.

2020 ◽  
Author(s):  
Som Kumar Shrestha ◽  
Don Vicendese ◽  
Bircan Erbas
Keyword(s):  
Nutritional Status ◽  
Water Purification ◽  
Rural Areas ◽  
Interactive Effects ◽  
P Value ◽  
Child Undernutrition ◽  
Sanitation And Hygiene ◽  
Z Scores ◽  
Height For Age ◽  
Weight For Age

Abstract Background: Evidence of the influence of water, sanitation and hygiene (WASH) behaviors on childhood nutritional status is inconsistent. Few studies have examined their interactive effects. This study aimed to examine associations and interactions between WASH variables and preschool child undernutrition. Methods: Data from a nationally representative sample of 2352 children assessed during the 2016 Nepal Demographic and Health Survey were analyzed by multi-variable linear regression to understand the association between height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) z-scores and WASH variables. Interactions between WASH variables, sex and area of residence on childhood nutritional status were also examined. Results: The mean z-score [standard deviation] for children’s WAZ, HAZ and WHZ scores were -1.33 [1.1], -1.52 [1.3] and -0.65 [1.1], respectively. A unit increase in cluster sanitation coverage was associated with an increase of 0.30 (95%CI: 0.12 to 0.48) for WAZ and 0.28 (95%CI: 0.001 to 0.56) for HAZ scores. Household water purification practice was associated with an increase of 0.24 (95%CI: 0.07 to 0.41) in WHZ score. Handwashing practice with water and soap was associated with an increase of 0.15 (95%CI: 0.04 to 0.25) in WAZ and 0.13 (95%CI: 0.01 to 0.24) in WHZ scores. The effect of water purification practice was higher for rural areas compared to urban settings for HAZ scores (p-value for interaction=0.02). Conclusions: Consistent with findings from other countries in the South Asian region, findings of this study highlight the potential importance of good WASH practices, and therefore the potential of WASH interventions, to contribute to improved nutritional status in rural Nepal.

scholarly journals Differences between WHO Growth Standards and China Growth Standards in Assessing the Nutritional Status of Children Aged 0–36 Months Old

2019 ◽  
Vol 17 (1) ◽  
pp. 251
Author(s):  
Qianling Tian ◽  
Xiao Gao ◽  
Tingting Sha ◽  
Qiong He ◽  
Gang Cheng ◽  
...  
Keyword(s):  
Nutritional Status ◽  
World Health ◽  
Growth Standards ◽  
The World ◽  
Z Scores ◽  
Nutritional Status Of Children ◽  
Height For Age ◽  
Weight For Age ◽  
China’S Growth

Background: At present, whether to use the World Health Organization’s (WHO) growth standards or native growth standards to assess the nutritional status in a given population is unclear. This study aimed to compare the differences between the WHO’s growth standards and China’s growth standards in assessing the nutritional status of children aged 0~36 months. Methods: We used z-scores to evaluate the nutritional status of children. The weight-for-age z-scores (WAZs), length/height-for-age z-scores (LAZ/HAZs), and weight-for-length/height z-scores (WLZ/WHZs) were calculated using the WHO’s growth standards and China’s growth standards. MeNemar’s test was used to compare the nutritional status of children. Results: The results in this study showed that there were differences between the WHO’s standards and China’s standards in assessing children’s nutritional status except for stunting and obesity. The prevalence of underweight assessed using China’s standards was higher than when using the WHO’s standards (except when 3 and 36 months old). The prevalence of wasting was significantly higher when assessed using China’s standards than when using the WHO’s standards from 12 to 36 months. The prevalence of overweight was higher when assessed using the WHO’s standards from 3 to 8 months. Conclusions: Both the WHO’s and China’s growth standards are useful measures in assessing children’s nutritional status but with key significant differences. Therefore, caution should be taken in selecting appropriate measures in a given population.

Catch-up growth in children after repair of Tetralogy of Fallot

2012 ◽  
Vol 22 (5) ◽  
pp. 507-513 ◽  
Author(s):  
Fabio Carmona ◽  
Lucas S. Hatanaka ◽  
Marco A. Barbieri ◽  
Heloisa Bettiol ◽  
Roseli B. D. Toffano ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Economic Status ◽  
Growth Restriction ◽  
Socio Economic Status ◽  
Z Scores ◽  
Catch Up ◽  
Residual Lesions ◽  
Height For Age ◽  
Weight For Age

AbstractPurposeTo evaluate the growth of children after repair of Tetralogy of Fallot, as well as the influence of residual lesions and socio-economic status.MethodsA total of 17 children, including 10 boys with a median age of 16 months at surgery, were enrolled in a retrospective cohort, in a tertiary care university hospital. Anthropometric (as z-scores), clinical, nutritional, and social data were collected.ResultsWeight-for-age and weight-for-height z-scores decreased pre-operatively and recovered post-operatively in almost all patients, most markedly weight for age. Weight-for-height z-scores improved, but were still lower than birth values in the long term. Long-term height-for-age z-scores were higher than those at birth, surgery, and 3 months post-operatively. Most patients showed catch-up growth for height for age (70%), weight for age (82%), and weight for height (70%). Post-operative residual lesions (76%) influenced weight-for-age z-scores. Despite the fact that most patients (70%) were from low-income families, energy intake was above the estimated requirement for age and gender in all but one patient. There was no influence of socio-economic status on pre- and post-operative growth. Bone age was delayed and long-term-predicted height was within mid-parental height limits in 16 children (93%).ConclusionChildren submitted to Tetralogy of Fallot repair had pre-operative acute growth restriction and showed post-operative catch-up growth for weight and height. Acute growth restriction could still be present in the long term.

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