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Mixed probiotics decrease the incidence of stage II-III necrotizing enterocolitis and death: A systematic review and

Tianliang Jiang1, Huai Zhang1, Xianrong Xu1

  • 1Department of Prevention Medicine, School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, 311121, China.

Microbial Pathogenesis
|November 2, 2019
PubMed
Summary

Probiotics significantly reduce the risk of necrotizing enterocolitis (NEC) and death in premature infants. Combination probiotics, particularly in Asian populations, show superior efficacy in preventing NEC and mortality.

Keywords:
Meta-analysisNecrotizing enterocolitisPreventionProbiotics

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Area of Science:

  • Neonatal Medicine
  • Gastroenterology
  • Microbiology

Background:

  • Necrotizing enterocolitis (NEC) is a critical condition affecting premature infants, leading to significant morbidity and mortality.
  • Evaluating preventive strategies for NEC is crucial for improving infant outcomes.

Purpose of the Study:

  • To assess the efficacy of probiotic supplementation in preventing stage II-III NEC in premature infants.
  • To compare the effectiveness of different probiotic formulations and their impact on NEC and mortality rates.

Main Methods:

  • A meta-analysis of clinical studies published between 1990 and 2018 was conducted.
  • Searches were performed in PubMed, Medline, and Embase databases.
  • Statistical analyses included heterogeneity testing (Q-test) and publication bias assessment (funnel plot, Egger's test).

Main Results:

  • Probiotic supplementation significantly reduced the risk of stage II-III NEC (RR=0.51) and overall mortality (RR=0.69).
  • Mixed probiotics and Lactobacillus demonstrated efficacy in preventing NEC, while Bifidobacterium and Saccharomyces did not show significant effects.
  • Mixed probiotics were effective in reducing mortality, with a notable significant effect observed in the Asian population.

Conclusions:

  • Probiotics are effective in decreasing the risk of stage II-III NEC and associated mortality in premature infants.
  • Combination probiotic therapy offers superior protection against NEC and death compared to single-species probiotics, especially in Asian infants.