The Role of Probiotics Prophylaxis Duration in Preventing Necrotizing Enterocolitis: A Single-Center Retrospective Study

Background: Necrotizing enterocolitis (NEC) is a common life-threatening disease in very low birth-weight (VLBW) infants. Probiotic prophylaxis is often used in the VLBW infants as a protective factor. Objectives: This retrospective study assessed risk factors of NEC and observed the effect of probiotic prophylaxis duration on NEC. Methods: The study encompassed 237 VLBW neonates admitted to the NICU of the First Affiliated Hospital of the Anhui Medical University, Anhui Province, who received probiotic prophylaxis. In this study, the participants’ clinical characteristics, treatments, and outcomes were compared between the NEC (n = 19) and non-NEC (n = 218) groups. Moreover, factors associated with NEC were analyzed by logistic regression, and the probiotic prophylaxis duration was analyzed by receiver operating characteristic (ROC) curves. Results: As the analysis revealed, 19 (8.02%) neonates were suffering from NEC. The probiotic prophylaxis duration (OR = 0.693, 95% CI = 0.574 - 0.836) was associated with the risk of NEC after adjusting for gestational age, duration of empirical antibiotic use, RBC transfusion, and late-onset sepsis. For the probiotic prophylaxis duration, the areas under curve was 0.870, the ideal cutoff was 10.5 days, and the sensitivity and specificity were 0.844 and 0.895, respectively. Conclusions: Probiotic prophylaxis was associated with the decreased risk of NEC. The findings revealed that an effective duration of use might be more than 10.5 days of probiotic prophylaxis application.