Prophylactic Probiotics for Preterm Infants: A Systematic Review and Meta-Analysis of Observational Studies.
Neonatology
; 109(2): 105-12, 2016.
Article
em En
| MEDLINE
| ID: mdl-26624488
ABSTRACT
BACKGROUND:
Necrotizing enterocolitis (NEC) is a major morbidity and cause of mortality in preterm neonates. Probiotics seem to have a beneficial role in preventing NEC, which is confirmed in meta-analyses of randomized controlled trials (RCTs). We therefore aimed to review and confirm the efficacy of probiotics in preterm neonates obtained in observational studies.OBJECTIVE:
To assess the effects of prophylactic probiotics in preterm infants.METHODS:
A meta-analysis was performed searching PubMed, EMBASE, CENTRAL (the Cochrane Library) and www.clinicaltrials.gov. Reference lists of reviews of RCTs were also searched. Included studies were observational studies that enrolled preterm infants <37 weeks of gestational age. Trials were included if they administered any probiotics and measured at least one clinical outcome (e.g. NEC, all-cause mortality, sepsis or long-term development scores). Two authors extracted characteristics and outcomes from included studies. The Newcastle-Ottawa Scale was used for quality assessment. A random-effects meta-analysis model was used, and heterogeneity was assessed by the I2 test.RESULTS:
We included 12 studies with 10,800 premature neonates (5,144 receiving prophylactic probiotics and 5,656 controls). The meta-analysis showed a significantly decreased incidence of NEC (risk ratio, RR = 0.55, 95% confidence interval, 95% CI, 0.39-0.78; p = 0.0006) and mortality (RR = 0.72, 95% CI, 0.61-0.85; p < 0.0001). Sepsis did not differ significantly between the two groups (RR = 0.86, 95% CI, 0.74-1.00; p = 0.05).CONCLUSIONS:
Probiotic supplementation reduces the risk of NEC and mortality in preterm infants. The effect sizes are similar to findings in meta-analyses of RCTs. However, the optimal strain, dose and timing need further investigation.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Probióticos
/
Enterocolite Necrosante
/
Doenças do Prematuro
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
/
Newborn
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article