Efficacy of probiotics and synbiotics combined with phototherapy vs phototherapy alone in neonatal hyperbilirubinemia: a systematic review and meta-analysis of randomized controlled trials
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View abstract on PubMed
Summary
This summary is machine-generated.Probiotics and synbiotics (live microorganisms) combined with phototherapy significantly reduce hospitalization and phototherapy duration for neonatal hyperbilirubinemia. However, their effect on discharge bilirubin levels remains inconsistent, necessitating further research.
Area Of Science
- Neonatal Medicine
- Gastroenterology
- Microbiology
Background
- Phototherapy is the standard treatment for neonatal hyperbilirubinemia but can have side effects.
- Probiotics and synbiotics are explored as adjuncts to reduce phototherapy duration and associated risks.
- Previous studies show mixed results regarding the efficacy of probiotics/synbiotics in neonatal hyperbilirubinemia management.
Purpose Of The Study
- To evaluate the efficacy of probiotics/synbiotics as adjuncts to phototherapy in treating neonatal hyperbilirubinemia.
- To analyze the impact on phototherapy duration, hospitalization length, and serum bilirubin levels.
- To investigate subgroup effects based on gestational age and specific probiotic/synbiotic strains.
Main Methods
- A systematic meta-analysis of 17 randomized controlled trials (RCTs) involving 2017 neonates.
- Data were collected from PubMed, ClinicalTrials.gov, and Cochrane Library up to May 2025.
- Risk of bias was assessed using the Cochrane RoB2 tool; data analysis was performed using Review Manager 5.4.1.
Main Results
- Probiotic/synbiotic supplementation significantly reduced hospitalization duration (MD, -0.35 days) and phototherapy duration (MD, -13.10 hours).
- Serum bilirubin levels showed significant reductions at 24 hours (MD, -1.45 mg/dL) and borderline reduction at 72 hours (MD, -0.54 mg/dL).
- However, discharge bilirubin levels were lower in the phototherapy-only group, indicating inconsistent effects.
Conclusions
- Probiotics/synbiotics combined with phototherapy may shorten treatment duration and hospitalization for neonatal hyperbilirubinemia.
- The inconsistent findings regarding discharge bilirubin and observed heterogeneity highlight the need for further research.
- Future multicenter RCTs focusing on specific populations and probiotic/synbiotic strains are recommended.
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