Effect of probiotics on C-reactive protein levels in preterm infants: Secondary analysis of a randomized controlled trial

Article type: Research Article

Authors: Agrawal, S.^{a; b; c} | Rao, S.^{a; b; c} | Nathan, E.A.^{d; e} | Patole, S.^{a; c; *}

Affiliations: [a] Department of Neonatal Paediatrics, KEM Hospital, Perth, WA, Australia | [b] Department of Neonatal Paediatrics, Princess Margaret Hospital for Children, Perth, WA, Australia | [c] Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia | [d] Women and Infants Research Foundation, King Edward Memorial Hospital for Women, Perth, WA, Australia | [e] School of Women’s and Infants’ Health, University of Western Australia, Perth, WA, Australia

Correspondence: [*] Address for correspondence: Prof Sanjay Patole, FRACP, Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, 374 Bagot Rd, Subiaco WA 6008, Australia. Tel.: +6164582222; E-mail: Sanjay.patole@health.wa.gov.au.

Abstract: BACKGROUND:Excessive inflammation is associated with adverse outcomes in preterm infants. C- reactive protein (CRP) is a marker of inflammation/infection. Probiotics have anti-inflammatory properties. Randomized controlled trials (RCTs) in preterm infants have not reported effect of probiotics on CRP. AIM:To evaluate effect of probiotics on CRP in preterm infants who had participated in a RCT of Bifidobacterium breve (B. breve) m-16v. METHODS:Data on all infants (GA <33 weeks, n = 159) enrolled in the RCT was analyzed. For study purpose, CRP <15 mg/L and ≤10 mg/L was considered normal for the first week, and thereafter respectively. Mixed logistic regression modelling was used to assess probiotic effect on CRP levels. RESULTS:There were 1579 CRP measurements (Probiotic: 851 vs. Placebo: 728). Baseline characteristics and number [Median (IQR)] of CRP estimations per infant [l0 (5, 20) vs. 10 (6, 17), p = 0.861] were comparable between probiotic vs. placebo group. There was no significant difference in the proportion of infants with high CRP over time (treatment by weekly time points interaction, p = 0.187), and across all time points between probiotic and placebo group (adjusted OR: 1.62, 95% CI: 0.91–2.88, p = 0.102) CONCLUSION:B. breve m-16v did not decrease CRP levels in preterm infants born <33 weeks.

Keywords: C-reactive protein, inflammation, preterm infant, probiotic, Bifidobacterium breve

DOI: 10.3233/NPM-181763

Journal: Journal of Neonatal-Perinatal Medicine, vol. 11, no. 2, pp. 165-171, 2018