Review ArticleProbiotic supplement reduces risk of necrotizing enterocolitis and mortality in preterm very low-birth-weight infants: an updated meta-analysis of 20 randomized, controlled trials☆,☆☆
Section snippets
Search strategy and selection criteria
We searched PubMed, Embase, and CBM databases for studies published between January 1985 and March 2011, with the search terms “very low birth weight infant” or “low birth weight infant” or “extremely low birth weight infant” or “premature infant” or “preterm infant” and “lactobacillus” or “probiotics” or “saccharomyces” or “bifid bacterium”. No language restriction was applied. The reference lists of identified studies and key review articles were also searched. The inclusion criteria of this
Demographic characteristics of the studies
Our search yielded a total of 150 studies on probiotic supplement for preterm VLBW infants (Fig. 1). After reviewing each abstract or original publication and extracting data from the publications, 7 RCTs were excluded because of an absence of clinically relevant data even after contacting the investigators [23], [24], [25], [26], [27], [28], [29]. Finally, we identified 20 original RCTs (16 in English, 4 in Chinese), including a total of 3816 patients [12], [13], [14], [15], [16], [30], [31],
Discussion
Previous studies investigating probiotic supplement for preterm VLBW infants have provided inconsistent results, and most of those studies involved no more than a few hundred preterm infants, which is too few to assess any effect reliably. Meta-analysis has been recognized as an important tool to define the effect of clinical interventions more precisely and to identify potentially important sources of between-study heterogeneity. A meta-analysis of 11 studies showed the dramatic benefits of
References (47)
- et al.
Necrotising enterocolitis
Lancet
(2006) - et al.
Probiotics for prevention of necrotising enterocolitis in preterm neonates with very low birthweight: a systematic review of randomised controlled trials
Lancet
(2007) - et al.
Efficacy of Bifidobacterium breve and Lactobacillus casei oral supplementation on necrotizing enterocolitis in very-low-birth-weight preterm infants: a double-blind, randomized, controlled trial
Am J Clin Nutr
(2011) - et al.
Meta-analysis in clinical trials
Control Clin Trials
(1986) - et al.
The effects of probiotics on feeding tolerance, bowel habits, and gastrointestinal motility in preterm newborns
J Pediatr
(2008) - et al.
Enteral feeding of premature infants with Saccharomyces boulardii
Early Hum Dev
(2003) - et al.
Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates
J Pediatr
(2005) - et al.
The effect of a bifidobacter supplemented bovine milk on intestinal permeability of preterm infants
Early Hum Dev
(2007) - et al.
Oral supplementation with probiotics in very-low-birth-weight preterm infants: a randomized, double-blind, placebo-controlled trial
Am J Clin Nutr
(2009) - et al.
Probiotics and prevention of atopic disease: 4-years follow-up of a randomised placebo controlled trial
Lancet
(2003)
Lack of effects of oral probiotics on growth and neurodevelopmental outcomes in preterm very low birth weight infants
J Pediatr
Necrotizing enterocolitis-150 years of fruitless search for the cause
Neonatology
New therapies and preventive approaches for necrotizing enterocolitis: report of a research planning workshop
Pediatr Res
Neonatal necrotizing enterocolitis: clinical considerations and pathogenetic concepts
Pediatr Dev Pathol
Necrotizing enterocolitis
N Engl J Med
Necrotising enterocolitis hospitalisations among neonates in the United States
Paediatr Perinat Epidemiol
Probiotics reduce the risk of necrotizing enterocolitis in preterm infants: a meta-analysis
Neonatology
Updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates
Pediatrics
Probiotics for prevention of necrotising enterocolitis: an updated meta-analysis
Klin Padiatr
Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial
JAMA
A randomized placebo-controlled comparison of 2 prebiotic/probiotic combinations in preterm infants: impact on weight gain, intestinal microbiota, and fecal short-chain fatty acids
J Pediatr Gastroenterol Nutr
Effect of Bifidobacterium lactis on the incidence of nosocomial infections in very-low-birth-weight infants: a randomized controlled trial
Neonatology
Cited by (154)
Gastrointestinal microbiome, what is behind faecal microbiota transplantation?
2021, New Microbes and New InfectionsHistorical aspects of probiotic use to prevent necrotising enterocolitis in preterm babies
2019, Early Human DevelopmentNecrotizing Enterocolitis Pathophysiology: How Microbiome Data Alter Our Understanding
2019, Clinics in PerinatologyProbiotic use in clinical practice: Results of a national survey of gastroenterologists and nutritionists
2019, Revista de Gastroenterologia de MexicoNecrotizing enterocolitis: Bench to bedside approaches and advancing our understanding of disease pathogenesis
2023, Frontiers in Pediatrics
- ☆
Conflict of interest statement: We declare that we have no conflict of interest.
- ☆☆
Role of funding source: None.