(P07-032-23) Effect of Early Neonatal Administration of Oral Lactiplantibacillus plantarum on Stool Iron Content in Infants in Dhaka, Bangladesh

Objectives: Evidence suggests that certain probiotic species can enhance host iron bioavailability, thereby offering a potential strategy to address iron deficiency when iron supplementation alone may be inadequate. However, few studies have assessed the effects of probiotics on iron status in infants. We examined whether early neonatal administration of Lactiplantibacillus plantarum ATCC 202195 (L. plantarum 202195) increases iron bioavailability, thereby reducing stool iron content among infants in Dhaka, Bangladesh.

Methods: This sub-study used data and samples collected during a double-blind, placebo-controlled phase 2 trial (clinicaltrials.gov identifier: NCT0518020). At 0-4 days of age, infants were randomized to 1 of 5 trial arms of placebo, or 1- or 7-day regimens of L. plantarum 202195 with or without fructooligosaccaride (FOS). Fecal iron was quantified using atomic absorption spectrometry in stool samples collected at day 14 of age from 307 out of a total of 496 infants. Effect of the 1-day and 7-day L. plantarum 202195 regimens, with or without FOS, on stool iron concentrations were assessed using linear regression models. Effect estimates were reported as mean percent difference relative to placebo with 95% confidence interval (CI).

Results: Mean stool iron concentration in the placebo group (n=53) was 4.3mg Fe/100g dry stool (95%CI: 3.3, 5.6). Relative to placebo, there was no difference in fecal iron concentration following 1-day (% difference= 9.8%, 95%CI: -19%, 49%; P=0.544, n=132) or 7-days of L. plantarum 202195 (% difference= -6.1%, 95%CI: -31%, 28%; P=0.685, n=122). Inferences were unchanged when trial arms were disaggregated to examine the effect of FOS: 1-day L. plantarum 202195 (% difference: -3.4%, 95%CI: -31%, 36%; P=0.842, n=70); 1-day L. plantarum 202195+ FOS (% difference: 27%, 95% CI: -10%, 80%; P=0.18, n=62); 7-day L. plantarum 202195 ( % difference: 1.3%, 95%CI: -29%, 45%; P=0.941; n=57); and 7-day L. plantarum 202195 + FOS (% difference: -12%, 95%CI: -38%, 24%; P=0.456; n=65).

Conclusions: The absence of an effect of neonatal administration of L. plantarum 202195 (with or without FOS) on stool iron content suggests this probiotic or synbiotic did not increase iron bioavailability among infants at 14 days of age in Dhaka, Bangladesh.

Funding Sources: The Bill and Melinda Gates Foundation
Canadian Institutes of Health Research (CIHR)