Effect of enteral supplementation of neutral and acidic oligosaccharides in preterm infants on allergic diseases during the first year of life

Aim: Enteral administration of a prebiotic mixture of neutral and acidic oligosaccharides during the neonatal period in preterm infantsmay positively affect the Th2 response. Aim was to determine the effect of enteral supplementation of neutral and acidic (scGOS/ lcFOS/AOS) oligosaccharides during the neonatal period in preterm infants on the incidence of allergic diseases during the first year of life. Methods: In a randomised controlled trial, preterm infants (GA<32 weeks and/or BW<1500 g) were allocated to receive enteral scGOS/lcFOS/AOS supplementation or placebo (maltodextrin) between days 3 and 30 of life. Incidence of allergic disease (atopic dermatitis, bronchial hyperreactivity) was assessed by validated questionnaire. Both atopic dermatitis and bronchial hyperreactivity needed to be physician- diagnosed. Data were analysed by logistic regression analysis. Results: In total, 113 preterm infants were enrolled in the initial study. Of these 113, 99 were eligible for follow-up (11 died, 3 were excluded). To date, 92/99 (93%) infants participated in our follow-up study. Incidence of atopic dermatitis was not different in scGOS/lcFOS/ AOS- and placebo group (8/48 (17%)) versus (7/44 (16%)) respectively (p=0.92, OR 1.1 (0.35-3.20)) Incidence of bronchial hyperreactivity was not different between scGOS/lcFOS/AOS- or placebo group (14/48 (29%) versus 12/44 (27%)) respectively (p=0.84, OR 1.1 (0.44-2.73)). Adjustments for confounding factors (maternal education, parental history of atopy, smoking, and presence of pets at home) did not change the results of the primary analysis. Conclusion: Enteral administration of a prebiotic mixture of acidic and neutral oligosaccharides during the neonatal period in preterm infants does not decrease the risk of atopic dermatitis or bronchial hyperreactivity during the first year of life.