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Infant, Newborn, DiseasesNCT05945017

Probiotics and the Neurodevelopment in the Premature Infant <32 Weeks Gestational Age and <1500g

A study testing Infloran® -Berne, Switzerland- (Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748 in people with Infant, Newborn, Diseases and Infant Development, run by Fundacion Clinic per a la Recerca Biomédica at 1 site in Spain.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Unicentric, quasi-experimental, cohort study to evaluate the effect of combining two probiotics (Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748) in the neurodevelopment of preterm neonates below 32 weeks' gestation and a birthweight under 1,500 g. Read more about this study

Who is it for?
Ages Up to 32 weeks
Conditions the study is for
Infant, Newborn, Diseases, Infant Development
What is being tested?
Infloran® -Berne, Switzerland- (Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748
Could I receive a placebo?
No, everyone receives an active treatment
How many people
233 participants
Where
1 siteSpain
Study dates
1 Jan 2014to 31 Dec 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Up to 32 weeks
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Premature infants under 32 weeks gestational age and less than 1500g birthweight.
  • Born at BCNatal Hospital Clínic between years 2014-2019.

Who cannot join

  • All neonates presenting with suspected congenital anomalies, inborn errors of metabolism, or genetic defects were excluded.
  • Infants with a suspected syndrome, or who have suffered events beyond the neonatal period, not related to prematurity, that could entail impairment in neurodevelopment (severe cranioencephalic trauma, oncological process, meningitis, or exposure to toxic substances)

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Neonataology Service, BCNatal Hospital Clinic Seu Maternitat

    Barcelona, 08028

Other trials in Spain

About this study

Unicentric, quasi-experimental, cohort study to evaluate the effect of combining two probiotics (Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748) in the neurodevelopment of preterm neonates below 32 weeks' gestation and a birthweight under 1,500 g. This probiotic combination has shown to be safe and beneficial in premature neonates in the prevention of NEC. The investigators hypothesised that this mixture would contribute to better neurodevelopmental outcomes of preterm neonates when assessed at 24 months corrected age. Additionally, neurodevelopment improved would be more relevant at 6 years of age, together with a better pattern of neuronal plasticity biomarkers.

Secondarily, this mixture of probiotics could reduce NEC, LOS, intraventricular haemorrhage and neonatal mortality in accordance with previous studies.

Being tested
Infloran® -Berne, Switzerland- (Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748
Keywords
Probiotics, Bifidobacterium bifidum, Lactobacillus acidophilus, Neurodevelopment, Prematurity, Late-onset sepsis
Medical subject headings
Infant, Newborn, Diseases, Premature Birth

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Infloran® -Berne, Switzerland- (Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748Dietary supplement

Study groups in NCT05945017
Study groupRoleWhat they receive
Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748ExperimentalDaily dose of 6x109 UFC Infloran® -Berne, Switzerland- (Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748) from 7 days of life until reaching a postmenstrual age of 34 weeks or discharge
Receives: Dietary Supplement: Infloran® -Berne, Switzerland- (Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748
ControlNo interventionUntreated control group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Degree of neurodevelopment at 24 months corrected age

    Normal neurodevelopment will be considered when no muscle tone changes, no impaired fine or gross motor coordination, Bayley scale score between above 84, no behaviour disorders or visual disability.

    Measured: 24 months

  2. Degree of neurodevelopment at 24 months corrected age

    Mild impairment will be considered if any of the following: muscle tone changes, impaired fine or gross motor coordination, Bayley scale score between 71-84, moderate behaviour disorders or mild visual disability.

    Measured: 24 months

  3. Degree of neurodevelopment at 24 months corrected age

    Moderate impairment will be diagnosed when suffering from any of the following: spastic diplegia, hemiplegia, seizures (non-febrile), Bayley scores between 50-70, severe behaviour disorders, moderate visual disability or mild-moderate hypoacusis.

    Measured: 24 months

  4. Degree of neurodevelopment at 24 months corrected age

    Severe impairment will be attributed to subjects with any of the following: spastic quadriplegia, choreoathetosis, ataxia, Bayley score <50, blindness or severe hypoacusis

    Measured: 24 months

  5. Degree of neurodevelopment at 6 years of age

    Wechsler Intelligence Scale for Children - Fifth edition. Ranges from below 69 to above 130. Scores from 90-109 indicate average, above it indicates above average and below, below average performance.

    Measured: 6 years

  6. Degree of neurodevelopment at 6 years of age

    Child behaviour checklist 6-18 years of age. 113 items about behaviour and social competence scored from 0 "absent" to 2 "occurs often"

    Measured: 6 years

  7. Degree of neurodevelopment at 6 years of age

    Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2). Parent/teacher self reporting form.

    Measured: 6 years

  8. Neuroplasticity biomarkers and intestinal permeability

    NeuN, Doublecortin, GFAP, GDNF, Ki67, Nrf2, BDNF, NGF, neurotrophin-1 (NT-1), neurotrophin-3 (NT-3), neurotrophin-4 (NT-4), DYRK1A, HIF1α, S100B i GSK3B. IL1B, IL6, IL8, IL10, IL12, TNF- α

    Measured: 6 years

Secondary outcomes (5)
  1. Incidence of necrotising enterocolitis

    cases fulfilling the stage II or above of the modified Bell's Criteria

    Measured: 40 weeks

  2. Mortality

    Proportion of dead participants before discharge

    Measured: 40 weeks

  3. Incidence of late onset sepsis

    positive blood culture beyond 72 hours of life

    Measured: 40 weeks

  4. Incidence of Intraventricular haemorrhage

    Grade I-IV

    Measured: 40 weeks

  5. Intensive care length of stay

    Days of intensive care

    Measured: 40 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Jul 2023
  2. Study start1 Jan 2014
  3. Primary completion31 Dec 2019
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Model description
Sequential study with consecutive recruitment with a washout period of 12 months between groups
Masking
None (open label)
Enrolment
233 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05945017
Sponsor's protocol ID
HCB/2021/0454
Status last verified
Aug 2023
First submitted
19 May 2023
Last updated
14 Aug 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Sjogren YM, Jenmalm MC, Bottcher MF, Bjorksten B, Sverremark-Ekstrom E. Altered early infant gut microbiota in children developing allergy up to 5 years of age. Clin Exp Allergy. 2009 Apr;39(4):518-26. doi: 10.1111/j.1365-2222.2008.03156.x. Epub 2009 Feb 9.

    PubMed 19220322
  • O'Reilly H, Johnson S, Ni Y, Wolke D, Marlow N. Neuropsychological Outcomes at 19 Years of Age Following Extremely Preterm Birth. Pediatrics. 2020 Feb;145(2):e20192087. doi: 10.1542/peds.2019-2087. Epub 2020 Jan 10.

    PubMed 31924688
  • Food and Agricultural Organization of the United Nations and World Health Organization. Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. World Health Organization, (2001).

  • Navarro-Tapia E, Sebastiani G, Sailer S, Toledano LA, Serra-Delgado M, Garcia-Algar O, Andreu-Fernandez V. Probiotic Supplementation During the Perinatal and Infant Period: Effects on Gut Dysbiosis and Disease. Nutrients. 2020 Jul 27;12(8):2243. doi: 10.3390/nu12082243.

    PubMed 32727119
  • Mai V, Young CM, Ukhanova M, Wang X, Sun Y, Casella G, Theriaque D, Li N, Sharma R, Hudak M, Neu J. Fecal microbiota in premature infants prior to necrotizing enterocolitis. PLoS One. 2011;6(6):e20647. doi: 10.1371/journal.pone.0020647. Epub 2011 Jun 6.

    PubMed 21674011
  • Underwood MA, Sohn K. The Microbiota of the Extremely Preterm Infant. Clin Perinatol. 2017 Jun;44(2):407-427. doi: 10.1016/j.clp.2017.01.005. Epub 2017 Mar 22.

    PubMed 28477669
  • Thomas JP, Raine T, Reddy S, Belteki G. Probiotics for the prevention of necrotising enterocolitis in very low-birth-weight infants: a meta-analysis and systematic review. Acta Paediatr. 2017 Nov;106(11):1729-1741. doi: 10.1111/apa.13902. Epub 2017 Jun 9.

    PubMed 28471478
  • Baucells BJ, Mercadal Hally M, Alvarez Sanchez AT, Figueras Aloy J. [Probiotic associations in the prevention of necrotising enterocolitis and the reduction of late-onset sepsis and neonatal mortality in preterm infants under 1,500g: A systematic review]. An Pediatr (Barc). 2016 Nov;85(5):247-255. doi: 10.1016/j.anpedi.2015.07.038. Epub 2015 Nov 21. Spanish.

    PubMed 26611880
  • Bi LW, Yan BL, Yang QY, Li MM, Cui HL. Which is the best probiotic treatment strategy to prevent the necrotizing enterocolitis in premature infants: A network meta-analysis revealing the efficacy and safety. Medicine (Baltimore). 2019 Oct;98(41):e17521. doi: 10.1097/MD.0000000000017521.

    PubMed 31593123
  • van den Akker CHP, van Goudoever JB, Shamir R, Domellof M, Embleton ND, Hojsak I, Lapillonne A, Mihatsch WA, Berni Canani R, Bronsky J, Campoy C, Fewtrell MS, Fidler Mis N, Guarino A, Hulst JM, Indrio F, Kolacek S, Orel R, Vandenplas Y, Weizman Z, Szajewska H. Probiotics and Preterm Infants: A Position Paper by the European Society for Paediatric Gastroenterology Hepatology and Nutrition Committee on Nutrition and the European Society for Paediatric Gastroenterology Hepatology and Nutrition Working Group for Probiotics and Prebiotics. J Pediatr Gastroenterol Nutr. 2020 May;70(5):664-680. doi: 10.1097/MPG.0000000000002655.

    PubMed 32332478
  • Alfaleh K, Anabrees J, Bassler D, Al-Kharfi T. Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev. 2011 Mar 16;(3):CD005496. doi: 10.1002/14651858.CD005496.pub3.

    PubMed 21412889
  • Wood NS, Marlow N, Costeloe K, Gibson AT, Wilkinson AR. Neurologic and developmental disability after extremely preterm birth. EPICure Study Group. N Engl J Med. 2000 Aug 10;343(6):378-84. doi: 10.1056/NEJM200008103430601.

    PubMed 10933736
  • Hortensius LM, van Elburg RM, Nijboer CH, Benders MJNL, de Theije CGM. Postnatal Nutrition to Improve Brain Development in the Preterm Infant: A Systematic Review From Bench to Bedside. Front Physiol. 2019 Jul 26;10:961. doi: 10.3389/fphys.2019.00961. eCollection 2019.

    PubMed 31404162
  • Cryan JF, O'Mahony SM. The microbiome-gut-brain axis: from bowel to behavior. Neurogastroenterol Motil. 2011 Mar;23(3):187-92. doi: 10.1111/j.1365-2982.2010.01664.x.

    PubMed 21303428
  • Yang I, Corwin EJ, Brennan PA, Jordan S, Murphy JR, Dunlop A. The Infant Microbiome: Implications for Infant Health and Neurocognitive Development. Nurs Res. 2016 Jan-Feb;65(1):76-88. doi: 10.1097/NNR.0000000000000133.

    PubMed 26657483

Questions about this trial

What is this clinical trial studying?

A study testing Infloran® -Berne, Switzerland- (Bifidobacterium bifidum NCDO 2203 and Lactobacillus acidophilus NCDO 1748 in people with Infant, Newborn, Diseases and Infant Development, run by Fundacion Clinic per a la Recerca Biomédica at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 14 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Degree of neurodevelopment at 24 months corrected age (time frame: 24 months). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05945017, which also lists 24 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Aug 2023.

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