Document Detail

Updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates.
MedLine Citation:
PMID:  20403939     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Systematic reviews of randomized, controlled trials (RCTs) indicate lower mortality and necrotizing enterocolitis (NEC) and shorter time to full feeds after probiotic supplementation in preterm (<34 weeks' gestation) very low birth weight (VLBW; birth weight <1500 g) neonates. The objective of this study was to update our 2007 systematic review of RCTs of probiotic supplementation for preventing NEC in preterm VLBW neonates.
METHODS: We searched in March 2009 the Cochrane Central register; Medline, Embase, and Cinahl databases; and proceedings of the Pediatric Academic Society meetings and gastroenterology conferences. Cochrane Neonatal Review Group search strategy was followed. Selection criteria were RCTs of any enteral probiotic supplementation that started within first 10 days and continued for > or =7 days in preterm VLBW neonates and reported on stage 2 NEC or higher (Modified Bell Staging).
RESULTS: A total of 11 (N = 2176), including 4 new (n = 783), trials were eligible for inclusion in the meta-analysis by using a fixed-effects model. The risk for NEC and death was significantly lower. Risk for sepsis did not differ significantly. No significant adverse effects were reported. Trial sequential analysis) showed 30% reduction in the incidence of NEC (alpha = .05 and .01; power: 80%).
CONCLUSIONS: The results confirm the significant benefits of probiotic supplements in reducing death and disease in preterm neonates. The dramatic effect sizes, tight confidence intervals, extremely low P values, and overall evidence indicate that additional placebo-controlled trials are unnecessary if a suitable probiotic product is available.
Girish Deshpande; Shripada Rao; Sanjay Patole; Max Bulsara
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Publication Detail:
Type:  Journal Article; Meta-Analysis     Date:  2010-04-19
Journal Detail:
Title:  Pediatrics     Volume:  125     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-03     Completed Date:  2010-05-18     Revised Date:  2011-10-19    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  921-30     Citation Subset:  AIM; IM    
Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia.
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MeSH Terms
Enteral Nutrition
Enterocolitis, Necrotizing / mortality,  prevention & control*
Infant, Newborn
Infant, Premature, Diseases / mortality,  prevention & control*
Infant, Very Low Birth Weight*
Probiotics / therapeutic use*
Randomized Controlled Trials as Topic
Survival Rate
Comment In:
Nat Rev Gastroenterol Hepatol. 2010 Jul;7(7):358   [PMID:  20626073 ]
Pediatrics. 2010 Sep;126(3):e742-3; author reply e743-5   [PMID:  20810715 ]
Pediatrics. 2010 Sep;126(3):e741-2; author reply e743-5   [PMID:  20810714 ]
Pediatrics. 2010 Sep;126(3):e740-1; author reply e743-5   [PMID:  20810713 ]
Arch Dis Child Educ Pract Ed. 2011 Oct;96(5):199   [PMID:  21653736 ]
Pediatrics. 2010 May;125(5):1071-2   [PMID:  20421256 ]
Pediatrics. 2010 May;125(5):1068-70   [PMID:  20403934 ]
J Pediatr. 2010 Nov;157(5):864-5   [PMID:  20955861 ]

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