Probiotics for Prevention of Necrotizing Enterocolitis in Preterm Infants

Summary

A Cochrane review [Abstract] 1 included 24 studies with a total of over 5 000 subjects. Included trials were highly variable with regard to enrolment criteria (that is birth weight and gestational age), baseline risk of necrotizing enterocolitis (NEC) in the control groups, timing, dose, formulation of the probiotics, and feeding regimens. In a meta-analysis of trial data, enteral probiotics supplementation significantly reduced the incidence of severe NEC (stage II or more) (typical relative risk (RR) 0.43, 95% CI 0.33 to 0.56; 20 studies, n=5 529 and in hihg quality studies RR 0.43, 95% CI 0.31 to 0.59; 11 trials, n=4 473) and mortality (typical RR 0.65, 95% CI 0.52 to 0.81; 17 studies, n=5 112 and in hihg quality studies RR 0.71, 95% CI 0.55 to 0.91; 10 trials, n=4 386). There was no evidence of significant reduction of nosocomial sepsis (typical RR 0.91, 95% CI 0.80 to 1.03; 19 studies, n=5 338). The included trials reported no systemic infection with the supplemental probiotics organism. Probiotics preparations containing either lactobacillus alone or in combination with bifidobacterium were found to be effective.