Bifidobacterium infantis as a probiotic in preterm infants: a systematic review and meta-analysis

BackgroundBifidobacterium infantis has special abilities to utilise human milk oligosaccharides. Hence we hypothesised that probiotic supplements containing B. infantis may confer greater benefits to preterm infants than probiotic supplements without B. infantis.MethodsA systematic review with meta-analysis was conducted according to standard guidelines. We selected RCTs evaluating probiotics compared to placebo or no treatment in preterm and/or low birth weight infants. Probiotic effects on Necrotizing Enterocolitis (NEC), Late Onset Sepsis (LOS) and Mortality were analysed separately for RCTs in which the supplemented probiotic product contained B. infantis and those that did not contain B. infantis.Results67 RCTs were included (n = 14,606), of which 16 used probiotics containing B. infantis (Subgroup A) and 51 RCTs did not (Subgroup B) Meta-analysis of all RCTs indicated that probiotics reduced the risk of NEC, LOS, and mortality. The subgroup meta-analysis demonstrated greater reduction in the incidence of NEC in subgroup A than subgroup B [(relative risk in subgroup A: 0.38; 95% CI, 0.27-0.55) versus (0.67; 95% CI, 0.55-0.81) in subgroup B; p value for subgroup difference: 0.01].ConclusionsThese results provide indirect evidence that probiotic supplements that include B. infantis may be more beneficial for preterm infants. Well-designed RCTs are necessary to confirm these findings.ImpactEvidence is emerging that beneficial effects of probiotics are species and strain specific.This systematic review analyses if supplementation provides an advantage to preterm infants.This is the first systematic review evaluating the effects of probiotics containing . in preterm infants.The results of this systematic review provides indirect evidence that probiotics that include may be more beneficial for preterm infants. These results will help in guiding future research and clinical practice for using as a probiotic in preterm infants.

Automated summary

This study suggests that probiotic supplements containing Bifidobacterium infantis may provide greater benefits to preterm infants. Further well-designed trials are needed to confirm these findings.