[Prophylactic probiotics for preventing necrotizing enterocolitis and reducing mortality in very low birth weight...

To systematically evaluate the efficacy and safety of probiotic supplementation for preventing necrotizing enterocolitis (NEC) and reducing mortality in preterm very low birth weight (VLBW) infants.

The randomized controlled trials (RCTs) about probiotics for preventing NEC in preterm neonates were searched in PubMed, EMbase, Cochrane Central Register of Controlled Trials (CENTRAL), the ISI Web of Knowledge databases, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), Weipu and Wanfang Data from their establishment to March 2014. The Cochrane Collaboration's RevMan 5.1 Software was used for a Meta analysis.

A total of 21 RCTs involving 4 607 preterm VLBW infants were eligible for inclusion in the Meta analysis. The Meta analysis showed that probiotic supplement was associated with a significantly decreased risk of NEC in preterm VLBW infants (RR=0.47; 95%CI: 0.35-0.62; P<0.001). Risk of mortality was also significantly reduced in the probiotic group (RR=0.63; 95%CI: 0.51-0.78; P<0.01). Probiotic supplement did not decrease the risk for sepsis (RR=0.87; 95%CI: 0.72-1.06; P=0.17) and NEC related mortality (RR=0.68; 95%CI: 0.31-1.48, P=0.33).

The results confirm that probiotic supplement can reduce risk of NEC and mortality in preterm VLBW infants. However, the long-term effects and safety of probiotics need to be assessed in large trials.