نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار، مرکز تحقیقات بیماری‌های کودکان، دانشگاه علوم پزشکی گیلان، رشت، ایران

2 استادیار، مرکز تحقیقات بیماری‌های کودکان، دانشگاه علوم پزشکی گیلان، رشت، ایران

3 دانشجوی پزشکی، مرکز تحقیقات بیماری‌های کودکان، دانشگاه علوم پزشکی گیلان، رشت، ایران

چکیده

زمینه و هدف: هیپربیلی روبینمی مشکل شایع نوزادان طی هفته اول زندگی است. یکی از مکانیسم‌های اصلی در ایجاد و تشدید ایکتر، افزایش سیکل انتروهپاتیک توسط آنزیم بتاگلوکورونیداز روده‌ای است. با توجه به فقدان نسبی فلور باکتریایی در روده طی هفته اول زندگی، آمادگی میکروبیولوژیکی می‌تواند گردش انتروهپاتیک را به‌وسیله مهار فعالیت آنزیم بتاگلوکورونیداز کاهش دهد. با توجه به تفاوت‌های موجود در فلور باکتری‌های روده در نوزادان ترم با پرترم، مطالعه حاضر در کنار درمان با فتوتراپی به بررسی مقایسه درمانی پدیلاکت بر ایکتر نوزادان ترم و پرترم می‌پردازد.
مواد و روش‌ها: مطالعه حاضر یک مطالعه کارآزمایی بالینی در یک بازه زمانی 6 ماهه است. مطالعه روی 97 نوزاد ترم و پرترم 2 تا 15 روزه تحت تغذیه با شیر مادر انجام شد. به کلیه نوزادان علاوه بر فتوتراپی، 5 قطره پدی‌لاکت داده شد. متغیرهای جنس و ترم یا پرترم بودن و سن دقیق حاملگی و میزان بیلی‌روبین روزانه تا روز ترخیص ثبت و وارد نرم‌افزار SPSS شد.
یافته‌ها: میانگین، میانه و انحراف‌معیار میزان کاهش بیلی‌روبین طی بستری، در نوزادان ترم با پرترم تفاوتی نداشت (p=0.451). در گروه‌های مختلف سن حاملگی، میانه، میانگین و انحراف معیار میزان بیلی‌روبین کاهش‌یافته طی روز بستری تا ترخیص، تفاوت آماری آشکاری نشان نداد و سن‌های مختلف حاملگی به یک میزان به درمان پاسخ دادند (P=0.473).
نتیجه‌گیری: نوزادان پرترم در مقایسه با نوزادان ترم، پاسخ درمانی متفاوتی به پدی‌لاکت نشان ندادند و روند کاهشی بیلی‌روبین در هر دو گروه مشابه بود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comparing the Response to Pedilact in Term and Preterm Neonates under Phototherapy

نویسندگان [English]

  • Marjaneh Zarkesh 1
  • Seyyedeh Azade Hoseini Nouri 2
  • Yalda Navidi Moghaddam 3
  • Manijeh Tabrizi 2
  • Ehsan Kazem Nejad Leyli 1

1 Associate professor, Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran

2 Assistant professor, Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran

3 Medical student, Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran

چکیده [English]

Introduction: Hyperbilirubinemia is a common neonatal problem that occurs in about 60% of term and 80% of preterm infants during the first week of life. The increase of intestinal enteropathic cycle by intestinal beta-glucuronidase is one of the main mechanisms in the exacerbation of jaundice. Despite the relative lack of bacterial flora in the intestines of neonates during the first week of life and considering the differences in intestinal bacteria in term and preterm neonates, the present study evaluated the therapeutic response to pedilact in two groups of neonates.
Materials and Methods: This clinical trial study was performed on 97 term and preterm neonates aged 2 to 15 days after obtaining the approval of the Ethics Committee and parental consent. Inclusion criteria included age 3-14 days, serum bilirubin 15-22mg/dl, exclusive breastfeeding, and no risk factor for hemolysis. In addition to phototherapy, all infants received 5 drops of pedilact daily. Phototherapy conditions were the same in both groups. Serum bilirubin checked daily. The variables of sex, gestational age, and daily bilirubin level were recorded and compared.
Results: The minimum and the maximum gestational age of the neonates were 35 and 41 weeks, respectively. There was no difference between median, mean, and standard deviation of bilirubin reduction during hospitalization days between two groups (P= 0.451).
Conclusion: The results of this study indicate that the Micrococcus luteus SEHD031RS strain can be used as an effective microorganism in removing chromium from industrial wastewater or environmental bioremediation.

کلیدواژه‌ها [English]

  • Hyperbilirubinemia
  • Microbiota
  • Phototherapy
  • Premature birth
  • Synbiotics
  • Term birth
  1. Ullah S, Rahman K, Hedayati M.Hyperbilirubinemia in neonates:Types, causes, clinical examinations, preventive measures and treatments:A narrative review article. Iran J Public Health 2016; 45: 558-568.
  2. Martin RJ, Fanaroff AA, Walsh MC.Neonatal-perinatal medicine.10 th ed. Philadelphia: Elsevier; 2015.p.1016.
  3. Singh M.Jaundice.IN: Care of the newborn. 7th ed.New Dehli: Sagar publication: 2010:p.254-274.
  4. CHEN, Kewei; YUAN, Tianming. The role of microbiota in neonatal hyperbilirubinemia. American Journal of Translational Research, 2020, 12.11: 7459.
  5. Liu W, Liu H, Wang T, Tang X. Therapeutic effects of probiotics on neonatal jaundice. Pak J Med Sci 2015;31(5):1172-117.
  6. Armanian AM, Barakatian B, Hoseinzade M, Salehimehr N.Probiotics for the management of hyperbilirubinemia in preterm neonates.J maternal fetal neonatal field 2016;29(18):3009-3013.
  7. Didari T, Solki S, Mozaffari S, Nikfar S, Abdollahi M. A systematic review of the safety of probiotics. Expert opinion on drug safety. 2014;13(2):227-39.
  8. SANTOSA I, SHOJI H, ITOH S, SHIMIZU T. Roles of Probiotics in Reduction of Neonatal Jaundice in Term Newborns. Juntendo Medical Journal. 2022:JMJ21-0044.
  9. Chi C, Buys N, Li C, Sun J, Yin C. Effects of prebiotics on sepsis, necrotizing enterocolitis, mortality, feeding intolerance, time to full enteral feeding, length of hospital stay, and stool frequency in preterm infants: a meta-analysis. European journal of clinical nutrition. 2019;73(5):657-70.
  10. Chaudhari A, Bharti A, Dwivedi MK. Probiotics in the prevention and treatment of atopic skin diseases. InProbiotics in the Prevention and Management of Human Diseases 2022 (pp. 117-128). Academic Press.
  11. Bafeta A, Koh M, Riveros C, Ravaud P. Harms reporting in randomized controlled trials of interventions aimed at modifying microbiota: a systematic review. Annals of Internal Medicine. 2018;169(4):240-7.
  12. Sharma N, Chaudhary R, Panigrahi P. Quantitative and qualitative study of intestinal flora in neonates. Journal of global infectious diseases. 2012: 4:188.
  13. GRITZ, Emily C.; BHANDARI, Vineet. The human neonatal gut microbiome: a brief review. Frontiers in pediatrics, 2015, 3: 17.
  14. Yap PS, Chong CW, Ahmad Kamar A, Yap IK, Choo YM, Lai NM, Teh CS. Neonatal intensive care unit (NICU) exposures exert a sustained influence on the progression of gut microbiota and metabolome in the first year of life. Scientific reports. 2021; 11(1):1-4.
  15. Ahearn‐Ford S, Berrington JE, Stewart CJ. Development of the gut microbiome in early life. Experimental Physiology. 2022;107(5):415-21.
  16. Linehan K, Dempsey EM, Ryan CA, Ross RP, Stanton C. First encounters of the microbial kind: perinatal factors direct infant gut microbiome establishment. Microbiome Research Reports. 2022;2(2):10.
  17. Chen CH, Wu Q, Li MJ. [Management of Hyperbilirubinemia in Newborns and Related Issues]. Journal of Applied Clinical Pediatrics. 2011;14 (26):1132.
  18. Jia HY. Effect of oral probiotics on treatment of neonates with hyperbilirubinemia and its influence on immune function. J Clin Med Pract. 2015; 19(7):104-106.
  19. Zahed Pasha Y, Ahmadpour-Kacho M, Ahmadi Jazi A, Gholinia H. Effect of Probiotics on Serum Bilirubin Level in Term Neonates with Jaundice; A Randomized Clinical Trial. International Journal of Pediatrics. 2017; 5(10):5953-8.
  20. Ahmadipour S, Fallahi A, Rahmani P. Probiotics for infantile colic. Clinical Nutrition Experimental. 2020 1;31:1-7.
  21. Pedilact Zisttakhmir, Available at: http://zisttakhmir.com/product/Pedilact/lang/2. Accessed on Aug. 08, 2017.
  22. Torkaman M, Mottaghizadeh F, KhosraviMH,2, Najafian B, Amirsalari S, Afsharpaiman S. TheEffectof ProbioticsonReducingHospitalization Duration inInfants With Hyperbilirubinemia.Iran J pediatr 2017;27(1):e5026.
  23. Chandrasekhar J, Varghese TP, Gopi A, Raj M, Sudevan R, et al.Treatment Effect of Probiotic Bacillus Clausii on Neonatal Jaundice in Late Preterm and Term Newborn Babies: An Experimental Study. Pediatr Ther 2017; 7: 326.
  24. Bisceglia M, Lndiro F, Riezzo G, Poerio V, Corapi U, Raimondi F. The effect of [28] probiotics in the management of neonatal hyperbilirubinemia. Acta Pediatri. 2009; 98(10):1579-81.
  25. Suganthi V, Das AG. Role of Saccharomyces boulardii in reduction of neonatal hyperbilirubinemia. Journal of Clinical and Diagnostic Research: JCDR. 2016;10(11):SC12.
  26. CHEN, Zhe, et al. Probiotics supplementation therapy for pathological neonatal jaundice: a systematic review and meta-analysis. Frontiers in pharmacology, 2017, 8: 432.
  27. DALBY, Matthew J.; HALL, Lindsay J. Recent advances in understanding the neonatal microbiome. F1000Research, 2020, 9.
  28. Butel MJ, Suau A, Campeotto F, Magne F, Aires J, Ferraris L, et al. Conditions of bifidobacterial colonization in preterm infants: a prospective analysis. J Pediatr Gastroenterol Nutr (2007) 44:577–82.10.1097/MPG.0b013e3180406b20.
  29. Healy DB, Ryan CA, Ross RP, Stanton C, Dempsey EM. Clinical implications of preterm infant gut microbiome development. Nature microbiology. 2021:1-2.
  30. Turroni F, Milani C, Ventura M, van Sinderen D. The human gut microbiota during the initial stages of life: Insights from bifidobacteria. Current Opinion in Biotechnology. 2022; 73:81-7.
  31. Panigrahi P. Probiotics and prebiotics in neonatal necrotizing enterocolitis: new opportunities for translational research. Pathophysiology. 2014;21(1):35-46.
  32. Jain N, Walker WA. Diet and host–microbial crosstalk in postnatal intestinal immune homeostasis. Nature reviews Gastroenterology & hepatology. 2015;12(1):14-25.
  33. Guaraldi F, Salvatori G. Effect of breast and formula feeding on gut microbiota shaping in newborns. Frontiers in cellular and infection microbiology. 2012;2:94.
  34. Estorninos E, Lawenko RB, Palestroque E, Sprenger N, Benyacoub J, Kortman GA, Boekhorst J, Bettler J, Cercamondi CI, Berger B. Term infant formula supplemented with milk-derived oligosaccharides shifts the gut microbiota closer to that of human milk-fed infants and improves intestinal immune defense: a randomized controlled trial. The American journal of clinical nutrition. 2022;115(1):142-53.
  35. Turta O, Selma-Royo M, Kumar H, Collado MC, Isolauri E, Salminen S, Rautava S. Maternal Intrapartum Antibiotic Treatment and Gut Microbiota Development in Healthy Term Infants. Neonatology. 2022;119(1):93-102.
  36. Salminen S, Gibson GR, McCartney AL, Isolauri E. Influence of mode of delivery on gut microbiota composition in seven year old children. Gut. 2004;53(9):1388-9.