Effectiveness of probiotics in the prophylaxis of necrotizing enterocolitis in preterm neonates: a systematic review and meta-analysis

Objective: To elucidate the benefits of using probiotics in the prevention of necrotizing enterocolitis (NEC) and its complications in preterm newborns. Method: This was a systematic review of randomized controlled trials, which included studies retrieved from three databases (MEDLINE, Embase, and LILACS), using a combination of the terms (necrotizing enterocolitis) AND (probiotics). Results: 11 randomized trials were included, totaling 2,887 patients, 1,431 in the probiotic group and 1,456 in the control group. There was a reduction in the incidence of NEC (NNT = 25), overall death (NNT = 34), and neonatal sepsis (NNT = 34) in the probiotic group compared to the control group. Patients that received probiotic supplementation had lower food reintroduction time (p < 0.001) and hospitalization time (p < 0.001) when compared to those not receiving probiotics. There was no difference in mortality caused by NEC. Conclusion: In premature newborns, the use of probiotics is effective as a prophylaxis for NEC and its complications. (C) 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.