ENTERAL SUPPLEMENTATION WITH PROBIOTICS IN PREMATURE INFANTS: A RETROSPECTIVE COHORT STUDY
Bibliographic record
Abstract
BACKGROUND: Necrotizing Enterocolitis (NEC) is the most devastating gastrointestinal emergency in preterm and very low birth weight infants. Despite preferential use of breastmilk, donor human milk, early treatment of sepsis, and a cautious approach to enteral feeding, the overall incidence of NEC remains high in Canada (1.5% to 9.3%) (2015 Canadian Neonatal Network). Probiotics, which are thought to prevent NEC by promoting colonization of the gut with beneficial organisms, have been drawing increasing attention worldwide. Expert bodies, including The Cochrane Collaboration, have indicated that a change in practice is warranted. OBJECTIVES: To assess the impact of an evidence-based practice change on multiple outcomes of an affected population; specifically, the impact of an enteral probiotic protocol on the rate of NEC in neonates born less than 33 weeks gestational age and/or less than 1500gm. DESIGN/METHODS: We conducted a retrospective cohort study with historical controls. Our NICU underwent an evidence-based change of practice in September 2014 with the implementation of a protocol for enteral administration of probiotics to infants born less than 33 weeks gestational age and/or less than 1500gm. The infants were provided with 0.5g of Florababy™, PO/NG/OG daily, starting with the first feed, and continued until discharge/transfer from hospital. We compared outcomes among infants admitted during the first 12 months of the practice change, to infants admitted 24 months prior. RESULTS: A total of 1018 infants were admitted to the NICU during the study period; 224 infants received probiotics. 390 infants formed the comparison group. All results are listed in the table below. Clinical outcomes of infants in the 2 cohorts: *N=363 for pre-probiotics cohort and 218 for post-probiotics cohort ** N=322 for pre-probiotics cohort and 188 for post-probiotics cohort CONCLUSION: Daily, enteral supplementation with probiotics (Florababy™) to eligible infants showed a reduction in NEC. Although this finding did not reach statistical significance due to power, this result remains clinically significant considering the devastating effects of NEC.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".