Effects of Probiotics on Gut Microbiomes of Extremely Preterm Infants in the Neonatal Intensive Care Unit: A Prospective Cohort StudyOriginal paper
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease, four years before the first published case study.
Read MoreWhat was studied?
This study investigated how probiotic supplementation affects the gut microbiota of extremely preterm infants in the neonatal intensive care unit. Probiotics were already known to reduce necrotizing enterocolitis (NEC) risk in this population, but the underlying mechanism was unclear. The researchers used a prospective cohort design to compare gut microbiota composition between infants who received probiotics and those who did not. They also examined whether probiotic exposure was associated with clinical outcomes such as NEC, late-onset sepsis, and duration of total parenteral nutrition.
Who was studied?
The cohort consisted of 120 extremely preterm neonates with a gestational age of 28 weeks or less. Infants were enrolled between August 2019 and December 2021 and divided into a study group that received probiotics and a control group that did not. This was a real-world clinical NICU population rather than a public dataset or animal model.
What were the most important findings?
Neonates who received probiotics had a significantly increased abundance of Lactobacillus compared with the control group (adjusted odds ratio 4.33, 95% CI 1.89 to 9.96, p = 0.009). The probiotic group also spent significantly fewer days on total parenteral nutrition (median 29.0 days versus 35.5 days, p = 0.004). In addition, the probiotic group had a significantly lower rate of late-onset sepsis than the control group.
What are the greatest implications of this study?
The findings suggest that probiotics may benefit extremely preterm infants partly by reshaping the gut microbiota toward greater Lactobacillus abundance, alongside reductions in parenteral nutrition duration and late-onset sepsis. This offers a plausible microbiota-mediated mechanism linking probiotic use to previously reported reductions in NEC and other neonatal morbidities. The results support continued clinical use of probiotics in extremely preterm NICU populations and point to gut microbiota composition as a relevant marker for future studies of probiotic mechanisms in this vulnerable group.