The effect of Lactobacillus acidophilus,Streptococcus thermophilus, and Bifidobacterium longum probiotics on bilirubin levels of neonates with hyperbilirubinemia
Abstract
Hyperbilirubinemia, a common illness in newborns that can lead to hospital readmission, has been treated with blue light phototherapy. This treatment, either on its own or in combination with probiotics, has shown fast and significant decreases in bilirubin levels in the blood, helping to speed up the fading of jaundice. This study aims to examine the effects of combining phototherapy with probiotics containing Lactobacillus acidophilus, Streptococcus thermophilus, and Bifidobacterium longum on newborns with hyperbilirubinemia. The study was conducted at Sultan Agung Islamic Hospital (RSI Sultan Agung), Semarang, using a randomized controlled trial design. It included newborns who were hospitalized between August and November 2022. The control group was administered phototherapy, whereas the treatment group received both phototherapy and probiotics for 7 days. SPSS software analysis demonstrated a statistically significant reduction in average levels of total and indirect bilirubin in the intervention group (6.50 mg/dl and 7.20 mg/dl) compared to the control group (6.70 mg/dl and 7.48 mg/dl). These findings highlight the potential effectiveness of the combined approach in controlling hyperbilirubinemia. The study proposes using probiotics as a safe additional treatment for neonatal hyperbilirubinemia, showing that it is well-tolerated and safe for the participants. Although the combination of probiotics and phototherapy did not show a significant difference compared to phototherapy alone, it did result in a faster average decrease in hyperbilirubinemia. This could reduce the necessity for hospital readmissions to manage this condition. The findings underscore the potential of probiotics as a helpful supplement to established treatment methods for newborn hyperbilirubinemia.
Downloads
License
© 2023 Author(s). Published by Sains Medika: Jurnal Kedokteran dan Kesehatan. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
How to Cite
References
Akagawa, S., Akagawa, Y., Yamanouchi, S., Teramoto, Y., Yasuda, M., Fujishiro, S., ... Kaneko, K. (2021). Association of neonatal jaundice with gut dysbiosis characterized by decreased bifidobacteriales. Metabolites, 11(887): 1-9. https://doi.org/10.3390/metabo11120887
American Academy of Pediatrics. (2022). Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics, 150(3). https://doi.org/10.1542/peds.2022-058859
Ansong-Assoku, B., Shah, S. D., Adnan, M., & Ankola, P. A. (2022). Neonatal Jaundice. Treasure Island (FL).
Bening Nurani, N., Aprillia Kadi, F., & Rostini, T. (2017). Incidence of Neonatal Hyperbilirubinemia based on Their Characteristics at Dr. Hasan Sadikin General Hospital Bandung Indonesia. Althea Medical Journal, 4(3): 431–434. Retrieved from http://dx.doi.org/10.15850/amj.v4n3.1195
Ding, J., Ma, X., Han, L., Zhao, X., Li, A., Xin, Q., ... Ren, Z. (2021). Gut microbial alterations in neonatal jaundice preand post-treatment. Bioscience Reports, 41(4): 1–13. https://doi.org/10.1042/BSR20210362
Itoh, S., Okada, H., Kuboi, T., & Kusaka, T. (2017). Phototherapy for neonatal hyperbilirubinemia. Pediatrics International, 59(9): 959–966. https://doi.org/10.1111/ped.13332
Jenabi, E., Eghbalian, F., Sabzehei, M. K., Reisi, R., & Talesh, S. T. (2022). The effect of probiotics and phototherapy combined application in comparison with phototherapy alone on bilirubin reduction in term neonates : A Randomized Controlled Trial. Research Square, 1–12. https://www.researchsquare.com/article/rs-1387582/v1.pdf
Liu, W., Liu, H., Wang, T., & Tang, X. (2015). Therapeutic effects of probiotics on neonatal jaundice. Pakistan Journal of Medical Sciences,31(5): 1172-1175. https://doi.org/10.12669/pjms.315.7921
Kamal, T.R., Afia, A.AA., Hablas, H.R., and Al-Shorbagy, M.S. (2019). Impact of probiotics on neonatal hyperbilirubinemia By. Al-Azhar Journal of Pediatrics, 22(46): 617-628. https://azjp.journals.ekb.eg/article_70275_ 9d701c6929afce04ff87fbed8f1c266e.pdf
Rao, S., Esvaran, M., Chen, L., Kok, C., Keil, A. D., Gollow, I., Simmer, K., Wemheuer, B., Conway, P., & Patole, S. (2023). Probiotic supplementation for neonates with congenital gastrointestinal surgical conditions: Guidelines for future research. Pediatric Research, 93(1): 49-55. https://doi.org/10.1038/s41390-022-02087-8
Rezki, D., Firmansyah, I., Darussalam, D., Yusuf, S., Sovira, N., Bakhtiar, B. (2023). The effectiveness of Lactobacillus reuteri on serum bilirubin levels in neonatal hyperbilirubinemia with phototherapy. 63(4):219-5. https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3024
Sampurna, M. T. A., Ratnasari, K. A., Etika, R., Hulzebos, C. V, Dijk, P. H., Bos, A. F., & Sauer, P. J. J. (2018). Adherence to hyperbilirubinemia guidelines by midwives, general practitioners, and pediatricians in Indonesia. PloS One, 13(4), e0196076. https://doi.org/10.1371/journal.pone.0196076
Sydney Chlldern Hospital. (2022). Phototherapy for neonatal jaundice-- CICU - SCH practice guideline. Australia: Sydney Children Center
Teran, C., Grandy, G., & Walker-Pizarro, N. (2021). The role of probiotics in preventing neonatal hyperbilirubinemia. Journal of Clinical Neonatology, 10(3): 178. https://doi.org/10.4103/jcn.jcn_202_20
Tsai, L., Lin, Y., Chen, T., Lin, Y., Ho, H., Kuo, W., Lin, H., Huang, Y., Wang, S., Chiu, Y., & Lin, C. (2022). Adjuvant probiotic Bifidobacterium animalis subsp. Lactis CP-9 improve phototherapeutic treatment outcomes in neonatal jaundice among full-term newborns: A randomized double-blind clinical study. Medicine, 101(45): 1-8. https://doi.org/10.1097/MD.0000000000031030
Ullah, S., Rahman, K., & Hedayati, M. (2016). Hyperbilirubinemia in Neonates: Types, Causes, Clinical Examinations, Preventive Measures and Treatments: A Narrative Review Article. Iranian Journal of Public Health, 45(5): 558-568. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935699/
Wang, J., Guo, G., Li, A., Cai, W.-Q., & Wang, X. (2021). Challenges of phototherapy for neonatal hyperbilirubinemia (Review). Experimental and Therapeutic Medicine, 21(3): 1–11. https://doi.org/10.3892/etm.2021.9662
Yanagi, T., Nakahara, S., & Maruo, Y. (2017). Bilirubin Uridine Diphosphate-glucuronosyltransferase Polymorphism as a Risk Factor for Prolonged Hyperbilirubinemia in Japanese Preterm Infants. The Journal of Pediatrics, 190: 159-162.e1. https://doi.org/10.1016/j.jpeds.2017.07.014
You, J. J., Qiu, J., Li, G. N., Peng, X. M., Ma, Y., Zhou, C. C., ... Xiao, Z. H. (2023). The relationship between gut microbiota and neonatal pathologic jaundice: A pilot case-control study. Frontiers in Microbiology, 14(March): 1–12. https://doi.org/10.3389/fmicb.2023.1122172
Zhang, X., Zeng, S., Cheng, G., He, L., Chen, M., Wang, M., Zhou, W., Qiu, H., & Wang, Z. (2022). Clinical Manifestations of Neonatal Hyperbilirubinemia Are Related to Alterations in the Gut Microbiota. Children, 9(764): 1-9. https://doi.org/10.3390/children9050764
