Prevention of Necrotizing Enterocolitis in Very Low Birth Weight Preterm Infants with Probiotics: a Systematic Review and Metaanalysis

Background:  Some studies have shown that probiotics reduce the incidence of Necrotizing enterocolitis (NEC) and sepsis; while other studies have not shown a significant difference of NEC and sepsis incidence. There are still no protocols or guidelines for the use of routine probiotics in Very Low Birth Weight (VLBW) preterm infants.Objective: A meta-analysis was assessed by reviewing up to date Randomized Controlled Trials (RCTs) to investigate the effectiveness of probiotics to prevent NEC. Data Sources: The Pubmed, Proquest, and Cochrane Library databases were searched from ۲۰۰۹ to ۲۰۱۹.Study selection: This meta-analysis was assessed according to PRISMA guidelines.Data extraction:  The inclusion criteria included RCTs of probiotics for  very low birth weight preterm babies; full text English articles; and those manuscripts published within the year of ۲۰۰۹ to ۲۰۱۹.Results:  The present research included nine studies. The incidence of NEC in the probiotic group were significantly lower (P = <۰.۰۰۰۰۱, R = ۰.۴۸). In the subgroup analysis, the incidence of NEC was lower in the multiple strain group and  lactobacillusgroup with P = ۰.۰۰۰۴ and ۰.۰۰۶ respectively. The incidence of sepsis was lower in the probiotic group with  P = ۰.۰۲; and the incidence of all-cause mortality was lower in the probiotic group with P = ۰.۰۲.Conclusion:  According to findings it can be stated that it is beneficial to use multiple strain probiotics and  lactobacillus  strain probiotics to prevent NEC in VLBW preterm babies.