Clinical efficacy of probiotics on feeding intolerance in preterm infants: a systematic review and meta-analysis

Area of Science:

• Neonatalogy
• Gastroenterology
• Microbiome Research

Background:

• Preterm infants possess immature physiological systems, increasing susceptibility to feeding intolerance (FI).
• Effective probiotic supplementation is vital for growth, development, and quality of life in preterm infants.
• Probiotics may mitigate the incidence and impact of feeding intolerance in this vulnerable population.

Purpose of the Study:

• To conduct a meta-analysis evaluating the clinical efficacy of probiotics in managing feeding intolerance (FI) in preterm infants.
• To synthesize evidence from existing studies to determine the impact of probiotics on key growth and clinical outcomes.

Main Methods:

• A systematic literature search was performed across PubMed, Web of Science, EMBASE, and MEDLINE databases (January 2002 - January 2021).
• Nine relevant studies involving 1,244 preterm infants with FI were included in the meta-analysis.
• RevMan 5.3 software was utilized for data analysis, including calculation of mean difference (MD) and assessment of publication bias.

Main Results:

• Probiotic intervention led to significant improvements in total intestinal feeding time (MD = -2.54) and weight gain (MD = 23.81).
• Maximum enteral feeding (MD = 6.41) and gastrointestinal tract improvement (OR = 2.34) were positively impacted by probiotics.
• The incidence of FI (OR = 0.38) and hospital stay duration (MD = -5.18) were significantly reduced in the probiotic group.

Conclusions:

• Probiotic supplementation demonstrates significant clinical benefits for preterm infants experiencing feeding intolerance.
• The findings support the use of probiotics to promote early growth and effectively manage FI in preterm neonates.
• This meta-analysis highlights the therapeutic potential of probiotics in neonatal care.