Prophylactic Probiotics for Preterm Infants: A Systematic Review and Meta-Analysis of Observational Studies

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 modReceived: June 8, 2015 Accepted after revision: September 24, 2015 Published online: December 2, 2015 Rie Olsen Faculty of Health and Medical Sciences University of Copenhagen Blegdamsvej 9, DK–2100 Copenhagen (Denmark) E-Mail rieolsen91 @ gmail.com © 2015 S. Karger AG, Basel 1661–7800/15/1092–0105$39.50/0