Table 2.
Studies of probiotics for neonatal diseasesa)
| Study | Description | No. of studies and infants | Results for effect of probiotic and/or synbiotic treatment vs. control |
|---|---|---|---|
| Systematic reviews and meta-analyses | |||
| Sharif et al. [82] 2020 | Included RCTs and quasi-RCTs of probiotics for infants born <32 weeks’ gestation and/ or <1,500 g | 56 Trials with 10,812 infants | NEC: RR, 0.54; 95% CI, 0.45–0.65 |
| Mortality: RR, 0.76; 95% CI, 0.65–0.89 | |||
| Late-onset invasive infection: RR, 0.89; 95% CI, 0.82–0.97 | |||
| Dermyshi et al. [80] 2017 | Included RCTs and observational studies of probiotics for infants born <34 weeks’ gestation and <1,500 g | 30 Trials with 8,622 infants and 14 observational studies with 13,779 infants | Severe NEC: RR, 0.57; 95% CI, 0.47–0.70 in RCTs, RR, 0.51; 95% CI, 0.37–0.70 in observational studies |
| All-cause mortality: RR, 0.77; 95% CI, 0.65–0.92 in RCTs, RR, 0.71; 95% CI, 0.62–0.81 in observational studies | |||
| Late-onset sepsis: RR, 0.88; 95% CI, 0.80–0.97 in RCTs, RR, 0.81; 95% CI, 0.69–0.96 in observational studies | |||
| Sawh et al. [81] 2016 | Included RCTs of probiotics for infants born <37 weeks’ gestation and/or <2,500 g | 42 Trials with 10,520 infants | Severe NEC: RR, 0.53; 95% CI, 0.42–0.66 |
| All-cause mortality: RR, 0.79; 95% CI, 0.68–0.93 | |||
| Culture-proven sepsis RR, 0.88; 95% CI, 0.77–1.00 | |||
| Rao et al. [86] 2016 | Included RCTs of probiotics for infants born <37 weeks’ gestation and/or <2,500 g | 37 Trials with 9,416 infants | Late-onset sepsis: RR, 0.86; 95% CI, 0.78–0.94 |
| Large randomized, controlled trials | |||
| Costeloe et al. [87] 2016 | RCT of probiotics (Bifidobacterium breve) for infants born 23–30 weeks’ gestation | 1,315 Infants | Late-onset sepsis: RR, 0.97; 95% CI, 0.73–1.29 |
| NEC ≥stage 2: RR, 0.93; 95% CI, 0.68–1.27 | |||
| Mortality: RR, 0.93; 95% CI, 0.67–1.30 | |||
| Jacobs et al. [88] 2013 | RCT of probiotics (Bifidobacterium infantis, Streptococcus thermophilus, and Bifidobacterium lactis) for infants born <32 weeks’ gestation and <1,500 g | 1,099 Infants | Late-onset sepsis: RR, 0.81, 95% CI, 0.61–1.08 |
| NEC: RR, 0.46, 95% CI, 0.23–0.93 | |||
| Mortality: RR, 0.97, 95% CI, 0.58–1.62 | |||
| Panigrahi et al. [85] 2017 | RCT of synbiotic (Lactobacillus plantarum plus fructooligosaccharide) for infants born ≥35 weeks and ≥2,000 g | 4,556 Infants | Sepsis and death: RR, 0.60; 95% CI, 0.48–0.74 |
| Culture-positive sepsis: RR, 0.22; 95% CI, 0.09–0.53 | |||
| Culture-negative sepsis: RR, 0.53; 95% CI, 0.30–0.92 | |||
| Lower-respiratory tract infection: RR, 0.66; 95% CI, 0.51–0.88 | |||
RCT, randomized controlled trial; NEC, necrotizing enterocolitis; RR, relative risk; CI, confidence interval.
a)
Table includes a selection of relevant studies; not all published studies are included.