Prophylactic Probiotics for Preterm Infants: A Systematic Review and Meta-Analysis of Observational Studies

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Rie Olsen1, Gorm Greisen, Morten Schrøder

  • 1Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Neonatology
|December 2, 2015
PubMed

Insights

Probiotic supplementation significantly reduces necrotizing enterocolitis (NEC) and mortality in preterm infants. This meta-analysis of observational studies confirms the benefits of probiotics for vulnerable newborns.

Area of Science:

  • Neonatal Medicine
  • Gastroenterology
  • Preventive Medicine

Background:

  • Necrotizing enterocolitis (NEC) is a leading cause of death in preterm infants.
  • Probiotics have shown promise in preventing NEC, supported by randomized controlled trial (RCT) meta-analyses.
  • This study focuses on observational data to confirm probiotic efficacy in preterm neonates.

Purpose of the Study:

  • To assess the effects of prophylactic probiotics in preterm infants.
  • To review and confirm the efficacy of probiotics in preventing NEC and other outcomes in preterm neonates based on observational studies.

Main Methods:

  • A comprehensive meta-analysis of observational studies was conducted.
  • Searches included PubMed, EMBASE, CENTRAL, and clinicaltrials.gov, along with reference lists.
  • Included studies involved preterm infants (<37 weeks gestational age) receiving probiotics, measuring outcomes like NEC, mortality, sepsis, and development.

Main Results:

  • The meta-analysis included 12 studies with 10,800 preterm neonates.
  • Probiotic use significantly decreased NEC incidence (RR = 0.55) and all-cause mortality (RR = 0.72).
  • No significant difference in sepsis rates was observed between probiotic and control groups (RR = 0.86).

Conclusions:

  • Probiotic supplementation effectively reduces the risk of NEC and mortality in preterm infants.
  • The observed effect sizes align with findings from RCT meta-analyses.
  • Further research is needed to determine optimal probiotic strains, dosages, and administration timing.
Abstract

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