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Probiotic strategies to prevent necrotizing enterocolitis in preterm infants: a meta-analysis

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Abstract

Purpose

We aimed to compare probiotics with placebo for necrotizing enterocolitis in preterm infants and to evaluate the safety and effect and strict effect of specific probiotic genera.

Methods

Data recorded until January 2019 were searched, and relevant academic articles from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were selected by two independent reviewers. Two reviewers independently included randomized controlled trials that compared probiotics and placebo in preterm infants. The outcomes included more than one of the following outcomes: incidence of necrotizing enterocolitis, necrotizing enterocolitis-related mortality, incidence of sepsis, and all-cause mortality. Two reviewers independently extracted data and assessed the risk of bias and quality of evidence.

Results

We identified 34 eligible studies of 9161 participants. This meta-analysis showed an overall advantage of probiotics to prevent the incidence of necrotizing enterocolitis (3.54%) and gut-associated sepsis (15.59%), and decrease mortality (5.23%) in preterm infants. A probiotic mixture showed a huge advantage and vitality in preventing necrotizing enterocolitis (2.48%) and gut-associated sepsis (18.39%), and in reducing mortality (5.57%) in preterm infants.

Conclusion

The probiotic mixture showed advantages over the single strains to decrease the incidences of necrotizing enterocolitis and gut-associated sepsis, and mortality in preterm infants.

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Acknowledgements

We wish to thank Tianjin Medical University for providing us with databases.

Funding

This work was supported by funding from standardization of endoscopic treatment of acute abdomen in children (number 14RCGFSY00150).

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Authors and Affiliations

  1. Department of the Graduate School, Tianjin Medical University, 22 Qixiangtai Road, Tianjin, China

    Le-wee Bi, Bei-lei Yan & Qian-yu Yang

  2. Department of General Surgery, Tianjin Children’s Hospital, 154 Machang Road, Tianjin, China

    Miao-miao Li & Hua-lei Cui

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LB conceptualized and designed the study, drafted the initial manuscript, and interpreted the data; BY conducted the initial analyses and drafted the initial manuscript; QY conceptualized and designed the study and supervised the analysis; ML conducted the meta-analyses, interpreted the data, and reviewed the manuscript; and HC conceptualized and designed the study, supervised the analysis, interpreted the data, and reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Hua-lei Cui.

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Bi, Lw., Yan, Bl., Yang, Qy. et al. Probiotic strategies to prevent necrotizing enterocolitis in preterm infants: a meta-analysis. Pediatr Surg Int 35, 1143–1162 (2019). https://doi.org/10.1007/s00383-019-04547-5

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  • DOI: https://doi.org/10.1007/s00383-019-04547-5

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