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Efficacy and safety of probiotics in preterm infants

K AlFaleh1, J Anabrees

  • 1Division of Neonatology, Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia.

Journal of Neonatal-Perinatal Medicine
|November 20, 2013
PubMed

Insights

Enteral probiotic supplementation significantly reduced severe necrotizing enterocolitis and mortality in infants. This meta-analysis of nineteen trials confirms probiotics are generally safe for infants, with no increased risk of systemic infection.

Area of Science:

  • Neonatal Medicine
  • Microbiology
  • Gastroenterology

Background:

  • Probiotics are live microbial supplements that enhance gut health.
  • Necrotizing enterocolitis (NEC) and mortality are significant risks for premature infants.
  • Previous studies suggested potential benefits of probiotics in infant gut health.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy and safety of enteral probiotic supplementation in infants.
  • To assess the impact of probiotics on severe necrotizing enterocolitis, mortality, and nosocomial sepsis.
  • To evaluate the risk of systemic infections associated with probiotic use in neonates.

Main Methods:

  • Updated systematic review and meta-analysis of nineteen randomized controlled trials.
  • Inclusion of over 2800 infants across the analyzed trials.
  • Statistical analysis using typical risk ratios (RR) and 95% confidence intervals (CI).

Main Results:

  • Enteral probiotic supplementation significantly reduced the incidence of severe necrotizing enterocolitis (RR 0.35, 95% CI 0.24 to 0.52).
  • Mortality was significantly reduced in infants receiving probiotics (RR 0.55, 95% CI 0.40 to 0.74).
  • No significant reduction in nosocomial sepsis was observed (RR 0.89, 95% CI 0.77 to 1.03), and no systemic infections were reported.

Conclusions:

  • Enteral probiotics are effective in reducing severe NEC and mortality in infants.
  • Probiotic supplementation is generally considered safe for infants, with no evidence of increased systemic infection risk.
  • Findings support the use of probiotics as a beneficial intervention in neonatal care, aligning with ESPGHAN recommendations.

Keywords:
NECProbioticsneonatal sepsispreterm

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