Impact of Prebiotic Supplementation on the Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants: A Systematic Review and Meta-Analysis

Author(s): Ghazala S. Virk MD, Sarah Hack MD, Haifa Arain MBBS, Asia Nasser kassem Alriashi MBBS, Muhammad Sohail S. Mirza MBBS*, Samra khalid MBBS, Mohammad Saad Hassan MBBS, Mahek Thorani MBBS, Binish Essani MBBS

Background: Necrotizing enterocolitis (NEC) is a tremendous cause of morbidity and mortality in neonates, especially in preterm infants. Probiotic supplementation has been proposed as a capability strategy to reduce NEC prevalence and enhance neonatal outcomes. Objectives: This systematic evaluation and meta-evaluation evaluated the efficacy of probiotics in lowering the prevalence of NEC, shortening the hospital period, and accelerating the fulfillment of complete enteral feeding in neonates.

Methods: A systematic search of databases recognized 2955 studies. After screening and high-quality assessment, eight randomized controlled trials (RCTs) met the inclusion standards. Data were analyzed using RevMan, with pooled effect sizes expressed as chance ratios (RRs) or standardized suggest differences (SMDs) with 95% confidence intervals (CIs). Heterogeneity was assessed the usage of I² statistics.

Results: The pooled analysis proved a huge discount in NEC incidence with probiotics (RR: 0.35, 95% CI: 0.24–0.50; p < 0.00001; I² = 0%), indicating a 65% lower risk compared to placebo. Probiotics additionally reduced the duration of clinic stay (SMD: –0.54, 95% CI: –0.95 to –0.14; p = 0.008; I² = 75%) and the time to attain complete enteral feeding (SMD: –0.54, 95% CI: –0.92 to –0.15; p = 0.006; I² = 81%). However, significant heterogeneity was found for the latter two results.

Conclusions: Probiotic supplementation appreciably reduces NEC risk and suggests the capacity for enhancing different neonatal outcomes, which include hospital stay period and feeding milestones. Variability in probiotic lines, dosing, and examination populations highlights the need for standardized protocols to optimize advantages.