Meta-regression did not show any significant association between the RR for NEC or LOS and the RR for BPD .
In conclusion , our results suggest that NEC and LOS prevention by probiotics does not affect the risk of developing BPD in preterm infants
Probiotic supplementation reduces the risk of necrotizing enterocolitis ( NEC ) and late-onset sepsis ( LOS )  in preterm infants , but it remains to be determined whether this reduction translates into a reduction of other complications .
We conducted a systematic review and meta- analysis to evaluate the possible role of probiotics in altering the risk of bronchopulmonary dysplasia ( BPD ) .
Bifidobacterium breve BBG-001 in very preterm infants: a randomised controlled phase 3 trial
BACKGROUND Probiotics may reduce  necrotising enterocolitis and late-onset sepsis after preterm birth . However , there has been concern about the rigour and generalisability of some trials and there is no agreement about whether or not they should be used routinely . We aim ed to test the effectiveness of the probiotic Bifidobacterium breve BBG-001 to reduce necrotising enterocolitis , late-onset sepsis , and death in preterm infants . METHODS In this multicentre , r and omised controlled phase 3 study ( the PiPS trial ) , we recruited infants born between 23 and 30 weeks ' gestational age within 48 h of birth from 24 hospitals in southeast Engl and . Infants were r and omly assigned ( 1:1 ) to probiotic or placebo via a minimisation algorithm r and omisation programme . The probiotic intervention was B breve BBG-001 suspended in dilute elemental infant formula given enterally in a daily dose of 8·2 to 9·2 log10 CFU ; the placebo was dilute infant formula alone . Clinicians and families were masked to allocation . The primary outcomes were necrotising enterocolitis ( Bell stage 2 or 3 ) , blood culture positive sepsis more than 72 h after birth ; and death before discharge from hospital . All primary analyses were by intention to treat . This trial is registered with IS RCT N , number 05511098 and EudraCT , number 2006 - 003445 - 17 . FINDINGS Between July 1 , 2010 , and July 31 , 2013 , 1315 infants were recruited ; of whom 654 were allocated to probiotic and 661 to placebo . Five infants had consent withdrawn after r and omisation , thus 650 were analysed in the probiotic group and 660 in the placebo group . Rates of the primary outcomes did not differ significantly between the probiotic and placebo groups . 61 infants ( 9 % ) in the probiotic group had necrotising enterocolitis compared with 66 ( 10 % ) in the placebo group ( adjusted risk ratio 0·93 ( 95 % CI 0·68 - 1·27 ) ; 73 ( 11 % ) infants in the probiotics group had sepsis compared with 77 ( 12 % ) in the placebo group ( 0·97 ( 0·73 - 1·29 ) ; and 54 ( 8 % ) deaths occurred before discharge home in the probiotic group compared with 56 ( 9 % ) in the placebo group ( 0·93 [ 0·67 - 1·30 ] ) . No probiotic-associated adverse events were reported . INTERPRETATION There is no evidence of benefit for this intervention in this population ; this result does not support the routine use of B breve BBG-001 for prevention of necrotising enterocolitis and late-onset sepis in very preterm infants . FUNDING UK National Institute for Health Research Health Technology Assessment programme
Meta-regression did not show any significant association between the RR for NEC or LOS and the RR for BPD .
In conclusion , our results suggest that NEC and LOS prevention by probiotics does not affect the risk of developing BPD in preterm infants
Probiotic supplementation reduces the risk of necrotizing enterocolitis ( NEC ) and late-onset sepsis ( LOS )  in preterm infants , but it remains to be determined whether this reduction translates into a reduction of other complications .
We conducted a systematic review and meta- analysis to evaluate the possible role of probiotics in altering the risk of bronchopulmonary dysplasia ( BPD ) .