A meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates
Necrotizing enterocolitis (NEC) is one of the most common acquired diseases of the gastrointestinal tract in preterm infants. Some randomized, controlled trials (RCTs) have indicated that probiotics may potentially lower the incidence of NEC and mortality. However, debate still remains about the saf...
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Associação Brasileira de Divulgação Científica
2014
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143209/ |
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pubmed-41432092014-09-08 A meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates Yang, Y. Guo, Y. Kan, Q. Zhou, X.G. Zhou, X.Y. Li, Y. Clinical Investigation Necrotizing enterocolitis (NEC) is one of the most common acquired diseases of the gastrointestinal tract in preterm infants. Some randomized, controlled trials (RCTs) have indicated that probiotics may potentially lower the incidence of NEC and mortality. However, debate still remains about the safety of probiotics and their influence on normal infant growth. We performed this meta-analysis to assess the safety and benefits of probiotic supplementation in preterm infants. We searched in PubMed, Embase, and Cochrane databases for English references, and in Wanfang, VIP, and CNKI databases for Chinese references. Ultimately, 27 RCTs (including 9 Chinese articles) were incorporated into this meta-analysis. Relative risk (RR) and weighted mean difference (WMD) were calculated using a random-effects or fixed-effects model, depending on the data type and heterogeneity. A total of 6655 preterm infants, including the probiotic group (n=3298) and the placebo group (n=3357), were eligible for inclusion in this meta-analysis. For Bell stage ≥I and gestational age <37 weeks, risk of NEC incidence was significantly lower in the probiotic group [RR=0.35, 95% confidence interval (CI)=0.27-0.44, P<0.00001]. For Bell stage ≥II or gestational age <34 weeks, there were likewise significant differences between the probiotic and placebo groups concerning NEC incidence (RR=0.34, 95%CI=0.25-0.48, P<0.00001; and RR=0.39, 95%CI=0.27-0.56, P<0.00001). Risk of death was significantly reduced in the probiotic group (RR=0.58, 95%CI=0.46-0.75, P<0.0001). In contrast, there was no significant difference concerning the risk of sepsis (RR=0.94, 95%CI=0.83-1.06, P=0.31). With respect to weight gain and the age at which infants reached full feeds, no significant differences were found between the probiotic and placebo groups (WMD=1.07, 95%CI=−0.21-2.34, P=0.10; and WMD=−1.66, 95%CI=−3.6-0.27, P=0.09). This meta-analysis has shown that, regardless of gestational age and NEC stage, probiotic supplementation could significantly reduce the risk of NEC in preterm infants. Analysis also indicated that such supplementation did not increase the incidence risk of sepsis or of mortality. Finally, the study showed that probiotic supplementation may have no adverse effect on normal feeding and growth. Associação Brasileira de Divulgação Científica 2014-08-01 /pmc/articles/PMC4143209/ /pubmed/25098619 http://dx.doi.org/10.1590/1414-431X20143857 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Yang, Y. Guo, Y. Kan, Q. Zhou, X.G. Zhou, X.Y. Li, Y. |
| spellingShingle |
Yang, Y. Guo, Y. Kan, Q. Zhou, X.G. Zhou, X.Y. Li, Y. A meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates |
| author_facet |
Yang, Y. Guo, Y. Kan, Q. Zhou, X.G. Zhou, X.Y. Li, Y. |
| author_sort |
Yang, Y. |
| title |
A meta-analysis of probiotics for preventing necrotizing enterocolitis in
preterm neonates |
| title_short |
A meta-analysis of probiotics for preventing necrotizing enterocolitis in
preterm neonates |
| title_full |
A meta-analysis of probiotics for preventing necrotizing enterocolitis in
preterm neonates |
| title_fullStr |
A meta-analysis of probiotics for preventing necrotizing enterocolitis in
preterm neonates |
| title_full_unstemmed |
A meta-analysis of probiotics for preventing necrotizing enterocolitis in
preterm neonates |
| title_sort |
meta-analysis of probiotics for preventing necrotizing enterocolitis in
preterm neonates |
| description |
Necrotizing enterocolitis (NEC) is one of the most common acquired diseases of the
gastrointestinal tract in preterm infants. Some randomized, controlled trials (RCTs)
have indicated that probiotics may potentially lower the incidence of NEC and
mortality. However, debate still remains about the safety of probiotics and their
influence on normal infant growth. We performed this meta-analysis to assess the
safety and benefits of probiotic supplementation in preterm infants. We searched in
PubMed, Embase, and Cochrane databases for English references, and in Wanfang, VIP,
and CNKI databases for Chinese references. Ultimately, 27 RCTs (including 9 Chinese
articles) were incorporated into this meta-analysis. Relative risk (RR) and weighted
mean difference (WMD) were calculated using a random-effects or fixed-effects model,
depending on the data type and heterogeneity. A total of 6655 preterm infants,
including the probiotic group (n=3298) and the placebo group (n=3357), were eligible
for inclusion in this meta-analysis. For Bell stage ≥I and gestational age <37
weeks, risk of NEC incidence was significantly lower in the probiotic group [RR=0.35,
95% confidence interval (CI)=0.27-0.44, P<0.00001]. For Bell stage ≥II or
gestational age <34 weeks, there were likewise significant differences between the
probiotic and placebo groups concerning NEC incidence (RR=0.34, 95%CI=0.25-0.48,
P<0.00001; and RR=0.39, 95%CI=0.27-0.56, P<0.00001). Risk of death was
significantly reduced in the probiotic group (RR=0.58, 95%CI=0.46-0.75, P<0.0001).
In contrast, there was no significant difference concerning the risk of sepsis
(RR=0.94, 95%CI=0.83-1.06, P=0.31). With respect to weight gain and the age at which
infants reached full feeds, no significant differences were found between the
probiotic and placebo groups (WMD=1.07, 95%CI=−0.21-2.34, P=0.10; and WMD=−1.66,
95%CI=−3.6-0.27, P=0.09). This meta-analysis has shown that, regardless of
gestational age and NEC stage, probiotic supplementation could significantly reduce
the risk of NEC in preterm infants. Analysis also indicated that such supplementation
did not increase the incidence risk of sepsis or of mortality. Finally, the study
showed that probiotic supplementation may have no adverse effect on normal feeding
and growth. |
| publisher |
Associação Brasileira de Divulgação Científica |
| publishDate |
2014 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143209/ |
| _version_ |
1613127215389605888 |