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Pathogenesis implication for necrotizing enterocolitis prevention in preterm very-low-birth-weight infants.
An-Chyi Chen1, Mei-Yung Chung, Jui Hsing Chang
1*Department of Pediatrics and School of Medicine, China Medical University Hospital, Taichung †Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung ‡Department of Pediatrics and School of Chinese Medicine, China Medical University Hospital §China Medical University School of Chinese Medicine, Taichung, Taiwan.
Journal of Pediatric Gastroenterology and Nutrition
|January 1, 2014
Summary
Necrotizing enterocolitis (NEC) is increasing in premature infants. Probiotics show promise for primary prevention by modulating gut health and inflammation, offering a significant advance.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Pediatric Surgery
Background:
- Necrotizing enterocolitis (NEC) incidence and mortality are rising in preterm very-low-birth-weight (PVLBW) infants.
- NEC progression is rapid, complicating treatment and secondary prevention efforts.
- Primary prevention is crucial due to the challenges in managing established NEC.
Purpose of the Study:
- To review current understanding of NEC pathophysiology in PVLBW infants.
- To identify optimal primary prevention strategies for NEC.
- To evaluate the role of probiotics in NEC prevention.
Main Methods:
- Review of 74 relevant scientific articles.
- Focus on pathophysiology and prevention strategies for NEC in PVLBW infants.
- Analysis of evidence from 19 randomized controlled trials on probiotics.
Main Results:
- Current prevention strategies (antenatal steroids, breast milk, cautious feeding) are insufficient.
- The leading hypothesis implicates enteral feeding with dysbiosis triggering inflammation in immature guts.
- Probiotics demonstrate significant benefits across multiple gut functions and defense mechanisms.
Conclusions:
- Probiotics represent a major advancement in NEC primary prevention.
- Addressing the complex pathogenesis of NEC is key for effective prevention.
- Further research supports probiotics for reducing NEC incidence in PVLBW infants.
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