BACKGROUND: @entity3166 ( @entity3166 ) is a major morbidity and cause of mortality in preterm neonates. Probiotics seem to have a beneficial role in preventing @entity3166 , which is confirmed in meta-analyses of randomized controlled trials (RCTs). We therefore aimed to review and confirm the efficacy of probiotics in preterm neonates obtained in observational studies. OBJECTIVE: To assess the effects of prophylactic probiotics in preterm @entity1 . METHODS: A meta-analysis was performed searching PubMed, EMBASE, CENTRAL (the Cochrane Library) and www.clinicaltrials.gov. Reference lists of reviews of RCTs were also searched. Included studies were observational studies that enrolled preterm @entity1 <37 weeks of gestational age. Trials were included if they administered any probiotics and measured at least one clinical outcome (e.g. @entity3166 , all-cause mortality, @entity295 or long-term development scores). Two authors extracted characteristics and outcomes from included studies. The Newcastle-Ottawa Scale was used for quality assessment. A random-effects meta-analysis model was used, and heterogeneity was assessed by the I2 test. RESULTS: We included 12 studies with 10,800 premature neonates (5,144 receiving prophylactic probiotics and 5,656 controls). The meta-analysis showed a significantly decreased incidence of @entity3166 (risk ratio, RR = 0.55, 95% confidence interval, 95% CI, 0.39-0.78; p = 0.0006) and mortality (RR = 0.72, 95% CI, 0.61-0.85; p < 0.0001). @entity295 did not differ significantly between the two groups (RR = 0.86, 95% CI, 0.74-1.00; p = 0.05). CONCLUSIONS: Probiotic supplementation reduces the risk of @entity3166 and mortality in preterm @entity1 . The effect sizes are similar to findings in meta-analyses of RCTs. However, the optimal strain, dose and timing need further investigation.

Prophylactic Probiotics for Preterm XXXX : A Systematic Review and Meta-Analysis of Observational Studies.

@entity1 :: ('9606', 'Species') :: ['infants'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis', 'Sepsis'] @entity3166 :: ('MESH:D020345', 'Disease') :: ['Necrotizing enterocolitis', 'NEC']
@entity1 :: (9606,Species) :: ['Infants']
