Effect of neonatal administration of Lactiplantibacillus plantarum ATCC 202195 on stool iron content and iron status in infants in Dhaka, Bangladesh

Background: Lactobacillus probiotics may enhance host iron bioavailability, offering a potential strategy to address iron deficiency; however, evidence of such effects in infants is lacking. Objective: To examine whether neonatal administration of Lactiplantibacillus plantarum ATCC 202195 (LP202195), with or without fructooligosaccharide (FOS), reduces stool iron content and improves iron status in young infants in Dhaka, Bangladesh. Methods: This study was a secondary analysis of a randomized placebo-controlled trial in which infants, 0-4 days of age, were randomly allocated to one of five groups: placebo, 1- or 7-day regimens of LP202195, with or without FOS. Fecal iron was quantified in stool samples collected at 14 days postnatal age (n=307) and serum ferritin concentration was measured at 2 months postnatal age (n= 251). Effects of the 1- and 7-day LP202195 regimens were estimated using linear regression and reported as mean percent differences relative to placebo, with 95% confidence intervals (95%CI). Results: In the combined analysis irrespective of FOS co-administration, there were no differences in fecal iron concentrations following 1-day (% difference=9.8%, 95%CI: -19%, 49%; P=0.54) or 7-days (% difference= -6.1%, 95%CI: -31%, 28%; P=0.69) of LP202195 administration, relative to placebo (geometric mean concentration=4.3mg Fe/100g dry stool (95%CI:3.3, 5.6); n=53). There were no effects of LP202195 administration on serum ferritin concentration following the 1-day (% difference=2.4%, 95%CI: -22%, 35%; P=0.86) or 7-day (% difference=1%, 95% CI: -23%, 33%; P=0.94) regimen, relative to placebo (geometric mean concentration=189 ng/mL (95%CI: 155, 232); n=55). Inferences were unchanged when intervention groups were disaggregated by FOS co-administration (P>0.05 for all). Conclusions: LP202195, when administered neonatally as a probiotic alone or synbiotic with FOS for 1 or 7 days, did not affect stool iron (2 weeks of age) or iron status (2 months of age) in Dhaka, Bangladesh.