scholarly journals Lactobacillus reuteri Colonisation of Extremely Preterm Infants in a Randomised Placebo-Controlled Trial

2021 ◽  
Vol 9 (5) ◽  
pp. 915
Author(s):  
Johanne E. Spreckels ◽  
Erik Wejryd ◽  
Giovanna Marchini ◽  
Baldvin Jonsson ◽  
Dylan H. de Vries ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Lactobacillus Reuteri ◽  
Controlled Trial ◽  
Probiotic Strain ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Head Growth ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Lactobacillus reuteri DSM 17938 supplementation reduces morbidities in very low birth weight infants (<1500 g), while the effect on extremely low birth weight infants (ELBW, <1000 g) is still questioned. In a randomised placebo-controlled trial (ClinicalTrials.gov ID NCT01603368), head growth, but not feeding tolerance or morbidities, improved in L. reuteri-supplemented preterm ELBW infants. Here, we investigate colonisation with the probiotic strain in preterm ELBW infants who received L. reuteri DSM 17938 or a placebo from birth to postmenstrual week (PMW) 36. Quantitative PCR was used on 582 faecal DNA samples collected from 132 ELBW infants at one, two, three, and four weeks, at PMW 36, and at two years of age. Human milk oligosaccharides were measured in 31 milk samples at two weeks postpartum. At least 86% of the ELBW infants in the L. reuteri group were colonised with the probiotic strain during the neonatal period, despite low gestational age, high antibiotic pressure, and independent of infant feeding mode. Higher concentrations of lacto-N-tetraose, sialyl-lacto-N-neotetraose c, and 6′-sialyllactose in mother’s milk weakly correlated with lower L. reuteri abundance. Within the L. reuteri group, higher L. reuteri abundance weakly correlated with a shorter time to reach full enteral feeding. Female sex and L. reuteri colonisation improved head growth from birth to four weeks of age. In conclusion, L. reuteri DSM 17938 supplementation leads to successful colonisation in ELBW infants.

Identifying Clinical Phenotypes in Extremely Low Birth Weight Infants – A Machine Learning Approach

2021 ◽  
Author(s):  
Felipe Yu Matsushita ◽  
Vera Lucia Jornada Krebs ◽  
Werther Brunow de Carvalho
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Phenotypic Characterization ◽  
Future Research ◽  
Low Birth Weight Infants ◽  
Mechanically Ventilated ◽  
Individualized Care ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract There is increasing evidence that patient heterogeneity significantly hinders advancement in clinical trials and individualized care. This study aimed to identify distinct phenotypes in extremely low birth weight infants. We performed an agglomerative hierarchical clustering on principal components. Cluster validation was performed by cluster stability assessment with bootstrapping method. A total of 215 newborns (median gestational age 27 [26–29] weeks) were included in the final analysis. Six clusters with different clinical and laboratory characteristics were identified: the “Mature” (Cluster 1; n = 60, 27.9%), the mechanically ventilated with “adequate ventilation” (Cluster 2; n = 40, 18.6%), the mechanically ventilated with “poor ventilation” (Cluster 3; n = 39, 18.1%), the “extremely immature” (Cluster 4; n = 39, 18.1%%), the neonates requiring “Intensive Resuscitation” in the delivery room (Cluster 5; n = 20, 9.3%), and the “Early septic” group (Cluster 6; n = 17, 7.9%). In-hospital mortality rates were 11.7%, 25%, 56.4%, 61.5%, 45%, and 52.9%, while severe intraventricular hemorrhage rates were 1.7%, 5.3%, 29.7%, 47.2%, 44.4%, and 28.6% in clusters 1,2,3,4,5, and 6, respectively (p < 0.001). Conclusions: Our cluster analysis in extremely preterm infants was able to characterize six distinct phenotypes. Future research should explore how better phenotypic characterization of neonates might improve care and prognosis.

Changes in thrombopoiesis and platelet reactivity in extremely low birth weight infants undergoing erythropoietin therapy for treatment of anaemia of prematurity

2005 ◽  
Vol 93 (01) ◽  
pp. 118-123 ◽  
Author(s):  
Francesco Cardona ◽  
Jens Schwindt ◽  
Angelika Berger ◽  
Stefan Kuhle ◽  
Monika Homoncik ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Platelet Reactivity ◽  
Controlled Trial ◽  
Extremely Low Birth Weight ◽  
Control Group ◽  
Thiazole Orange ◽  
Low Birth Weight Infants ◽  
Anaemia Of Prematurity ◽  
Randomised Controlled

SummaryErythropoietin (Epo) is frequently administered to premature infants to stimulate erythropoiesis. There is evidence from studies in animals and healthy adults that Epo also interacts with thrombopoiesis and platelet function.This study investigates the effect of Epo therapy on platelet reactivity, peripheral platelet counts and thiazole orange-positive (TO+) platelets in extremely low birth weight (ELBW) infants. In a randomised-controlled trial, ELBW infants with a birth weight ≤ 800g and a gestational age ≤ 32 weeks were either randomised to a group receiving Epo during the first weeks of life or to a control group. Our results show that thrombin receptor-activating peptide (TRAP-6) -induced expression of P-selectin increased significantly during the first two weeks of Epo treatment.With the exception of week five, the number of TO+ platelets was significantly higher during the first eight weeks in Epo-treated infants compared to controls. The increase of TO+ platelets was not paralleled by an increase in total platelet count.We can conclude that Epo therapy has a short-lasting effect on platelet reactivity toTRAP-6 in ELBW infants during the first two weeks of life.Furthermore, Epo therapy is associated with an increase in the number of TO+ platelets compared to controls.

scholarly journals Randomized controlled trial of prophylactic rectal stimulation and enemas on stooling patterns in extremely low birth weight infants

2013 ◽  
Vol 33 (11) ◽  
pp. 858-860 ◽  
Author(s):  
M Sáenz de Pipaón Marcos ◽  
M Teresa Montes Bueno ◽  
B SanJosé ◽  
M Gil ◽  
I Parada ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Controlled Trial ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Randomized Controlled
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