Effect of non-human neutral and acidic oligosaccharides on allergic and infectious diseases in preterm infants

Short-term supplementation of non-human neutral and acidic oligosaccharides during the first postnatal weeks may enhance the maturation of the immune response in preterm infants and may lead to less allergic and infectious diseases during the first year of life. In a randomized controlled trial, 113 preterm infants (gestational age <32 weeks and/or birth weight <1500 g) were allocated to receive enteral neutral and acidic oligosaccharide supplementation or placebo between days 3 and 30 of life. The median age at follow-up was not different in both groups: 12 months corrected age (interquartile range [IQR], 11–15) in the prebiotic mixture group and 12 months corrected age in the placebo group (IQR, 10–19), respectively. In addition, baseline patient, maternal, and environmental characteristics were not different between the prebiotic mixture (n = 48) and placebo (n = 46) group. Incidence of allergic and infectious diseases was assessed by validated questionnaires. In total, 94/98 (96 %) of the eligible, surviving infants participated in this follow-up study. The incidence of atopic dermatitis (odds ratio [OR], 0.80; 95 % confidence interval [CI], 0.24–2.67), bronchial hyper-reactivity (OR, 1.04; 95 % CI, 0.38–2.87) and infections of the upper respiratory (OR, 0.95; 95 % CI, 0.37–2.44), lower respiratory (OR, 1.03; 95 % CI, 0.37–2.88), and gastrointestinal (OR, 1.77; 95 % CI, 0.55–5.73) tract was not different between the groups. Adjustment for potential confounding factors did not change the results of the primary analysis. Conclusion: Short-term enteral supplementation of non-human neutral and acidic oligosaccharides during the neonatal period in preterm infants does not decrease the incidence of allergic and infectious diseases during the first year of life.