Prevention of Necrotizing Enterocolitis in Very Low Birth Weight Preterm Infants with Probiotics: A Systematic Review and Meta-analysis

Previous 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.  To this date there is still no protocols or guidelines in regards to the use of routine probiotics in very low birth weight preterm infants.

The present study was a meta-analysis research. Up to date RCTs were reviewed to see the effectiveness of probiotics in order to prevent necrotizing enterocolitis. Studies were searched through PubMed, ProQuest, and Cochrane Library searching engines from 2009 to 2019. This meta-analysis was assessed according to PRISMA guidelines. The inclusion criteria were randomized controlled trials of probiotics for very low birth weight preterm babies; full text English articles; and having been published from 2009 to 2019.

The findings of this study reveal that the incidence of NEC in the probiotic group was significantly low (p= <0.00001, R=0.48). In the subgroup analysis, the incidence of NEC was lower in the multiple strain group and Lactobacillus group with a P value of p= 0.0004 and 0.006 respectively. The incidence of sepsis was lower in the probiotic group with a P value of p= 0.02. Also, the incidence of all-cause mortality was lower in the probiotic group with a P value of p= 0.02.

According to the results of the present study, it can be stated that it is beneficial to use multiple strain probiotics and Lactobacillus strain probiotics to prevent necrotizing enterocolitis in very low birth weight preterm babies.