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Published on: January 27, 2019
Probiotic administration can prevent necrotizing enterocolitis in preterm infants: A meta-analysis
Christine S M Lau1, Ronald S Chamberlain2
1Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; Saint George's University School of Medicine, Grenada, West Indies.
Insights
Probiotic supplementation significantly reduces the risk of necrotizing enterocolitis (NEC) and mortality in very-low-birth-weight (VLBW) infants. This intervention also speeds up feeding advancements, improving outcomes for these vulnerable newborns.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Microbiome Research
Background:
- Necrotizing enterocolitis (NEC) is a critical gastrointestinal condition affecting 6-7% of very-low-birth-weight (VLBW) infants.
- Despite improved treatments, NEC survivors face significant long-term health challenges.
Purpose of the Study:
- To evaluate the efficacy of probiotic supplementation in reducing NEC incidence and associated complications in VLBW infants.
- To analyze the impact of probiotics on sepsis, mortality, and enteral feeding progression.
Main Methods:
- A meta-analysis of 20 randomized controlled trials (RCTs) involving 5982 preterm VLBW infants.
- Literature search conducted across PubMed, Cochrane, and Google Scholar (1966-2014).
- Analysis focused on NEC incidence, sepsis rates, overall mortality, and time to full enteral feeds.
Main Results:
- Probiotic use decreased NEC risk by 49.1% (RR=0.509; p<0.001) and overall mortality by 26.9% (RR=0.731; p=0.009).
- A trend towards reduced sepsis was observed (RR=0.919; p=0.137).
- Time to full enteral feeds was shortened by 1.2 days (MD: -1.217; p=0.011).
Conclusions:
- Probiotic supplementation offers significant protection against NEC and mortality in preterm VLBW infants.
- Further research is needed to identify optimal probiotic strains, dosages, and administration protocols.
Purpose:
Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in preterm infants, affecting ~6-7% of very-low-birth-weight (VLBW) infants. Early intervention and aggressive treatment has improved clinical outcomes, but considerable morbidity continues to accrue to NEC survivors. This meta-analysis examines the impact of probiotics on the incidence of NEC and complications among VLBW infants.
Methods:
A comprehensive literature search for all published randomized control trials (RCTs) assessing the use of probiotics to prevent NEC in VLBW infants was conducted using PubMed, Cochrane Central Registry of Controlled Trials, and Google Scholar (1966-2014). The incidences of NEC, sepsis, overall mortality, and time to reach full enteral feeds were analyzed.
Results:
20 RCTs involving 5982 preterm VLBW infants were analyzed. Risk of NEC was reduced by 49.1% (RR=0.509; 95% CI, 0.385-0.672; p<0.001), and overall mortality by 26.9% among infants receiving probiotics (RR=0.731; 95% CI, 0.577-0.926; p=0.009). An 8.1% reduction in sepsis was also observed in infants receiving probiotics (RR=0.919; 95% CI, 0.823-1.027; p=0.137). Time to reach full enteral feeds was reduced by 1.2 days among infants receiving probiotics (MD: -1.217; 95% CI, -2.151 to -0.283; p=0.011).
Conclusion:
The use of probiotic supplementation in preterm VLBW infants is associated with a significant reduction in the risk of NEC and overall mortality. Additional studies are required to determine the optimal genus, species, and dose of probiotic.
