Related Experiment Video
Updated: Jun 22, 2025
Probiotic Studies in Neonatal Mice Using Gavage
Published on: January 27, 2019
Effect of probiotic supplementation on the gut microbiota in very preterm infants: a systematic review
Kayleigh Vievermanns1, Thomas H Dierikx2,3, Nathalie J Oldenburger2
1Pediatric Gastroenterology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands k.vievermanns@hotmail.com.
Insights
Probiotic supplementation in preterm infants may alter gut microbiota, increasing beneficial bacteria and decreasing harmful ones. This may reduce risks of necrotizing enterocolitis (NEC) and other complications.
Area of Science:
- Neonatal research
- Microbiome science
- Gastroenterology
Background:
- Probiotic use in very preterm infants is linked to reduced necrotizing enterocolitis (NEC), sepsis, and mortality.
- The mechanisms by which probiotics confer these benefits, particularly their impact on gut microbiota, remain unclear.
Conclusions:
- Probiotic supplementation in preterm infants appears to promote a gut microbial profile with increased beneficial bacteria and reduced potentially pathogenic species.
- These microbial shifts may underlie the observed reduction in health complications like NEC.
- Further research employing omics technologies is needed to optimize probiotic mixtures and dosages for preterm infants.
Objective:
There is increasing evidence that probiotic supplementation in very preterm infants decreases the risk of necrotising enterocolitis (NEC), sepsis and mortality. The underlying mechanisms, including effects on the gut microbiota, are largely unknown. We aimed to systematically review the available literature on the effects of probiotic supplementation in very preterm infants on gut microbiota development.
Design:
A systematic review in Medline, Embase, Cochrane Library, CINAHL and Web of Science.
Setting:
Neonatal intensive care unit.
Patients:
Premature infants.
Intervention:
Probiotic supplementation.
Main Outcome Measures:
Gut microbiota.
Results:
A total of 1046 articles were screened, of which 29 were included. There was a large heterogeneity in study design, dose and type of probiotic strains, timepoints of sample collection and analysing techniques. Bifidobacteria and lactobacilli were the most used probiotic strains. The effects of probiotics on alpha diversity were conflicting; however, beta diversity was significantly different between probiotic-supplemented infants and controls in the vast majority of studies. In most studies, probiotic supplementation led to increased relative abundance of the supplemented strains and decreased abundance of genera such as Clostridium, Streptococcus, Klebsiella and Escherichia.
Conclusions:
Probiotic supplementation to preterm infants seems to increase the relative abundance of the supplemented strains with a concurrent decrease of potentially pathogenic species. These probiotic-induced microbial alterations may contribute to the decreased risk of health complications such as NEC. Future trials, including omics technologies to analyse both microbiota composition and function linked to health outcomes, are warranted to identify the optimal mixture and dosing of probiotic strains.
Prospero Registration Number:
CRD42023385204.
