To overcome traditional meta-analytical approach limitations, van den Akker et al.
However, these studies have failed to provide clinically meaningful recommendations. In recent years, the role of probiotic administration in preventing NEC has been also investigated through observational studies and randomized controlled trials (RCTs), whose results have been summarized in numerous systematic reviews and meta-analyses. Recent meta-analyses estimated that 7% of low BW infants in neonatal intensive care units are likely to develop NEC mortality varies from 10% to 30% and has remained largely unchanged since the initial disease description several decades ago.Įvidence of the protective role of human milk (HM) against NEC in preterm infants is robust.
Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality in preterm infants with low birth weight (BW) and gestational age (GA). Further trials are needed to confirm the present findings. Of note, most probiotic strains are evaluated in few trials and relatively small populations, and outcome data according to feeding type are not available for all RCTs. lactis Bb-12/B94 could reduce NEC risk with a different size effect according to feeding type. The subgroup analysis showed that Bifidobacterium lactis Bb-12/B94 was associated with a reduced risk of NEC stage ≥2 in both feeding type populations, with a discrepancy in the relative effect size in favour of exclusively HM-fed infants (OR 0.04 95% CrIs <0.01–0.49 vs. In the overall analysis, Lactobacillus acidophilus LB revealed the most promising effect for reducing NEC risk (odds ratio (OR), 0.03 95% credible intervals (CrIs), 0.00–0.21). Results: Fifty-one trials were included (10,664 infants, 29 probiotic interventions) 31 studies (19 different probiotic regimens) were suitable for subgroup analysis according to feeding. infants receiving formula (alone or with HM) was performed. A random-effects model was used a subgroup analysis on exclusively human milk (HM)-fed infants vs. Methods: A systematic review and network meta-analysis of randomized controlled trials (RCTs) on the role of probiotics in preventing NEC in preterm infants, focusing on the differential effect of type of feeding, was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Background: Recent evidence supports a role of probiotics in preventing necrotizing enterocolitis (NEC) in preterm infants.
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