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Updated: Aug 10, 2025
Probiotic Studies in Neonatal Mice Using Gavage
Published on: January 27, 2019
Growth and neuro-developmental outcomes of probiotic supplemented preterm infants-a systematic review and
Harshad Panchal1, Gayatri Athalye-Jape2,3, Shripada Rao4,5
1Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, WA, Australia.
Insights
Probiotic supplementation in preterm infants improved short-term weight gain but did not significantly impact long-term growth or neurodevelopmental outcomes. Further research with larger sample sizes is recommended for conclusive evidence.
Area of Science:
- Neonatal Medicine
- Microbiome Research
- Developmental Pediatrics
Background:
- Gut dysbiosis is linked to sepsis and necrotizing enterocolitis in preterm infants, potentially affecting long-term growth and neurodevelopment.
- Understanding the impact of interventions like probiotic supplementation is crucial for improving outcomes in this vulnerable population.
Approach:
- A systematic review and meta-analysis of 30 randomized controlled trials (RCTs) involving 4817 preterm infants was conducted.
- Searches included MEDLINE, EMBASE, EMCARE, Cochrane CENTRAL, and grey literature up to February 2022.
- Meta-analysis used random effects models, expressing effect sizes as SMD, MD, or RR with 95% CIs. Risk of Bias and Certainty of Evidence were assessed.
Key Points:
- Probiotic supplementation was associated with improved short-term weight gain (SMD 0.24, 95% CI 0.04-0.44, low certainty of evidence).
- No significant differences were observed in length (SMD 0.12, -0.13-0.36) or head circumference (SMD 0.09, -0.15-0.34) between groups.
- Probiotic use did not affect neurodevelopmental impairment (RR 0.91, 0.76-1.08, low certainty of evidence).
Conclusions:
- Probiotic supplementation shows a benefit for short-term weight gain in preterm infants.
- Current evidence suggests no significant impact on linear growth, head circumference, or neurodevelopmental outcomes.
- Larger, adequately powered RCTs are necessary to confirm these findings and guide clinical practice.
Abstract:
Gut dysbiosis is associated with sepsis and necrotizing enterocolitis in preterm infants, which can adversely affect long-term growth and neurodevelopment. We aimed to synthesise evidence for the effect of probiotic supplementation on growth and neurodevelopmental outcomes in preterm infants. MEDLINE, EMBASE, EMCARE, Cochrane CENTRAL, and grey literature were searched in February 2022. Only randomized controlled trials (RCTs) were included. Meta-analysis was performed using random effects model. Effect sizes were expressed as standardized mean difference (SMD), mean difference (MD) or risk ratio (RR) and their corresponding 95% confidence intervals (CI). Risk of Bias (ROB) was assessed using the ROB-2 tool. Certainty of Evidence (CoE) was summarized using GRADE guidelines. Thirty RCTs (n = 4817) were included. Meta-analysis showed that probiotic supplementation was associated with better short-term weight gain [SMD 0.24 (95%CI 0.04, 0.44); 22 RCTs (n = 3721); p = 0.02; I2 = 88%; CoE: low]. However, length [SMD 0.12 (95%CI -0.13, 0.36); 7 RCTs, (n = 899); p = 0.35; I2 = 69%; CoE: low] and head circumference [SMD 0.09 (95%CI -0.15, 0.34); 8 RCTs (n = 1132); p = 0.46; I2 = 76%; CoE: low] were similar between the probiotic and placebo groups. Probiotic supplementation had no effect on neurodevelopmental impairment [RR 0.91 (95%CI 0.76, 1.08); 5 RCTs (n = 1556); p = 0.27; I2 = 0%; CoE: low]. Probiotic supplementation was associated with better short-term weight gain, but did not affect length, head circumference, long-term growth, and neurodevelopmental outcomes of preterm infants. Adequately powered RCTs are needed in this area. Prospero Registration: CRD42020064992.
