Effect of probiotics on C‐reactive protein levels in preterm infants: results of a randomised controlled trial

PERTUSSIS VACCINATION IN PREGNANCY: INCREASING UPTAKE THROUGH FREE ANTENATAL CLINIC AVAILABILITY? Rania Abdou, Amanda Henry, Kate Kavanagh-Patel St George Hospital Background: To decrease neonatal pertussis incidence, The Australian Immunisation Handbook recommends administration of diphtheria/ tetanus/ pertussis (dTpa) vaccine to all pregnant women between 28–32 weeks’ gestation. Immunisation rates for Australian pregnant women have been low, with average dTpa uptake of about 30%. From 2015 NSW Health has provided free dTpa to antenatal patients from 28 weeks’ gestation. This study aims to identify dTpa uptake rates in women receiving antenatal care at St George Hospital, and any factors associated with uptake. Method: Retrospective audit September November 2016 of patient Antenatal Records, medication charts and dTpa vaccine administration register to identify the percentage uptake of dTpa vaccine in women in the third trimester of pregnancy receiving Antenatal Care at St George Hospital, Sydney. Demographic and pregnancy data were also collected. Results: Of 300 patients included to date, overall dTpa vaccination uptake rate is 67%, with 146 (73%) receiving dTpa at antenatal clinic and 54 (27%) through their GP. Average maternal age is 29.9 4.9 years, 33% are nulliparous, and 69% were born overseas, reflecting the multiethnic nature of our obstetric population. Updated results from the total cohort of 450 women will be presented. Conclusions: The dTpa vaccination uptake rate is approximately double reported vaccination rates pre-2015, and as most dTpa uptake in our population is via antenatal clinic, this is likely related to free dTpa provision by NSW Health. Interventions to further improve our dTpa coverage will include new antenatal record cards, pamphlets for culturally-and-linguistically-diverse women, staff education, and local GP education. CLINICAL ACCURACY AND USEFULNESS OF TRANSCUTANEOUS BILIRUBINOMETRY IN ASIAN NEWBORN INFANTS Abdul Alim Abdul Haium, Vora Shrenik Jitendrakumar, Vidal Eleah Nolasco, Agarwal Pratibha Keshav, Victor Samuel Rajadurai K K Women’s and Children’s Hospital, Singapore Background: This study aimed to establish correlation and agreement between Transcutaneous Bilirubin (TCB) and Total Serum Bilirubin (TSB) measurements using two different noninvasive devices in two different sites in racially diverse Asian population. Method: Newborn babies >34 weeks gestation and <15 days old, admitted to the well-baby nurseries were prospectively enrolled. Paired TCB measurements were taken using both JM103 and BiliCheck over forehead and sternum respectively within 30 minutes of TSB measurements. Babies on phototherapy were excluded. TSB measurements were performed using spectrophotometer from capillary blood samples. Correlation coefficient and levels of agreement obtained using paired student t-test and Bland-Altman analysis using SPSSv19. Results: The study population (n = 759) consists of Chinese (51.6%), Malay (30.1%), Indian (8.8) and other (9.4%) races. A total of 774 paired measurements analysed. The TSB levels ranged from 46–391 micromol/L. TCB measurements obtained using JM-103 over sternum gave the best correlation with TSB (r = 0.894, p < 0.001). Limit of agreement in this pair was 11.4 micromol/L (9.3-13.5). Very good correlation observed with paired TCB and TSB measurements using BiliCheck over forehead and sternum (JM103-Forehead vs. TSB r = 0.877, p < 0.001; BiliCheck-Forehead vs. TSB r = 0.847, p < 0.001; BiliCheck-Sternum vs. TSB r = 0.867, p < 0.001). Conclusions: TCB measurement using JM-103 and BiliCheck is clinically accurate and useful in assessing level of jaundice in term and late preterm Asian neonates, who are not on phototherapy. TCB measurement can be safely used as a screening tool for assessment of neonatal jaundice and invasive painful procedures for bilirubin estimation could be avoided EFFECT OF PROBIOTICS ON C-REACTIVE PROTEIN LEVELS IN PRETERM INFANTS: RESULTS OF A RANDOMISED CONTROLLED TRIAL Sachin Agrawal, Shripada Rao, Liz Nathan, Sanjay Patole King Edward Memorial Hospital, the Princess Margaret Hospital For Children, the Women and Infants Research Foundation, King Edward Memorial Hospital for Women, Perth, Australia Background: Excessive inflammation is associated with adverse outcomes in preterm infants. Creactive protein (CRP) is a marker of inflammation/infection. Probiotics are known to have anti-inflammatory properties. None of the randomised controlled trials (RCTs) in preterm infants have reported effect of probiotic supplementation on CRP levels. Aim: To evaluate the effect of probiotics on CRP levels in preterm infants who had participated in a RCT of probiotic Bifidobacterium breve (B. breve) m-16v supplementation. Methods: All infants (GA < 33 weeks, n = 159) enrolled in the RCT were included in the analysis. For the purpose of this study, CRP <15 mg/L and ?10 mg/L was considered normal for the first week, and there after respectively. Mixed logistic regression modelling was used to assess the effect of probiotics on CRP levels. Results: The baseline characteristics were comparable between the probiotic vs. placebo groups. The total number of CRP measurements was 851 vs. 728 in the probiotic vs. placebo group. There was no difference in the number of CRP estimations per infant between the two groups [Median (IQR): l0 (5, 20) vs. 10 (6, 17), p = 0.861]. There was no significant benefit of probiotics in reducing the proportion of infants with high CRP levels over time (treatment by weekly time points interaction, p = 0.187), and in the proportion of high CRP levels across all time points between probiotic and placebo groups (adjusted OR: 1.62, 95% CI: 0.91-2.88, p = 0.102) doi:10.1111/jpc.13494 Journal of Paediatrics and Child Health 53 (Suppl. 2) (2017) 3–117 © 2017 Paediatrics and Child Health Division (Royal Australasian College of Physicians) 3 Conclusion: Probiotic supplementation with B. breve m-16v did not decrease the CRP levels in preterm infants born at <33 weeks gestation.