68-2

49/110

rubin levels can reach more than 20 mg/dL, which requires treatments and may result in complica-tions such as kernicterus and damage in the neuro-logical system. Phototherapy is still the main therapy for significant jaundice, but this therapy is also associated with complications such as erythem-atous rashes, diarrhea, temperature instability, and dehydration. Also, the newborns who underwent phototherapy were separated from the mother and may interfere with the process of lactation. There-fore, prevention and other treatment of neonatal hyperbilirubinemia are very important7).Recently, some evidence suggests that gut micro-biota plays a critical role in maintaining metabolic and immune health, synthesis of vitamins, renewal of epithelial cells, fat storage, and maintaining intes-tinal barrier integrity. Probiotic supplementation can reduce bilirubin levels by several mechanisms such as reducing the enterohepatic circulation by the regulation of intestinal flora and also by increasing meconium evacuation8).Probiotics are being studied for their potential benefit in being a treatment of indirect hyperbiliru-binemia, but the potential of probiotics as preven-tion has not yet been clarified. The early gut micro-biota is often dominated by Escherichia. Clostridium, Bacteroides, and Bifidobacterium which is low in infants delivered by CS. Therefore, in this study, the primary objective was to examine the effect of Bifidobacterium on decreasing the bilirubin level in term neonates delivered by CS.SubjectsA total of 157 healthy term neonates delivered by CS in Sakuradai Maternity Clinic (January 2017 - December 2019), who was born at 36-40 weeks gestational age were included in this study. A total of 4 infants underwent phototherapy in both probi-otic group (n=1) and non-probiotic group (n=3), and these 4 infants were excluded from the study. Parents received information regarding probiotics and their benefits. Neonates whose parents agreed to the administration of the probiotic (n=54) were included in the probiotic group (n=99) and those whose parents refused will be included in the non-probiotic group (n=153). There were no infants who underwent phototherapy. This study was carried out by the opt-out method of the clinic website, and it was approved by the Institutional Review Board of Juntendo University Faculty of Medicine on 21 January 2019 (Registration Number: 18-159; Approval Number: 2018162).MethodologyThe Probiotic group was treated with a total of 20 doses (daily doses: 6 drops containing 10 x 108 CFU) of commercial probiotic products (Bifidobac︲terium animalis subsp. lactis BB-12, Bean Stalk Snow Co.,Ltd, Tokyo, Japan), which were given orally from the first day of life until day 20. The TcB levels were measured by using the transcuta-neous bilirubinometer (JM-103, Konica Minolta, Osaka). TcB levels were measured every day for the first 5 days of life. Data of each infant’s bilirubin levels, anthropometric measures, type of feeding, and mother’s anthropometric measures were gath-ered from medical records. Statistical analysesThe normally distributed variables (checked by a 1-sample Kolmogorov-Smirnov test) were compared using an independent sample t-test between the groups: Bilirubin levels on day 1 until day 5; Birth Weight; Body Weight gain; and one-month-old Body Weight. A Mann-Whitney U test was used to compare variables between the groups for variables that were not of a normal distribution. The chi-square test was used to compare between categorical variables in the two groups (gender, parity, and type of feeding). A p-value of <0.05 was considered statistically signif-icant. All statistical analyses were conducted using GraphPad Prism version 9.0.0 (GraphPad Software, La Jolla, California, USA).The total number of newborns included in this study was 153, with 54 newborns received probi-otics and 99 were taken as controls. Table 1 summa-rizes the demographic of infants and type of feeding (first five days of life). Comparison between the groups showed that there were no significant differences with respect to gender, parity, and type of feeding (breast milk, mix of breast milk and formula milk, and formula milk only). Probiotic supplementation caused a significant difference (p = 0.031) in the weight gain of probi-141MethodsResults