Assessment of food supplements for the prevention of necrotizing enterocolitis in preterm neonates: A systematic review and network meta-analysis

Comput Biol Med. 2023 Dec:167:107601. doi: 10.1016/j.compbiomed.2023.107601. Epub 2023 Oct 20.

Abstract

Background: The network meta-analysis (NMA) investigated the efficacy of six food supplements, namely glutamine, arginine, lactoferrin, prebiotics, synbiotics, and probiotics, in preventing necrotizing enterocolitis in premature infants.

Methods: MEDLINE, Embase, and Cochrane Library were searched. Randomized controlled trials comparing different food supplements for premature infants were included.

Results: Probiotics (OR, 0.47; 95% CrI, 0.33-0.63), arginine (OR, 0.38; 95% CrI, 0.14-0.98), glutamine (OR, 0.30; 95% CrI, 0.079-0.90), and synbiotics (OR, 0.13; 95% CrI, 0.037-0.37). were associated with a decreased incidence of NEC. Only probiotics (OR, 0.81; 95% CrI, 0.69-0.95) and lactoferrin (OR, 0.74; 95% CrI, 0.54-0.92) achieved lower risk of sepsis. Probiotics (OR, 0.58; 95% CrI, 0.40-0.79), prebiotics (OR, 0.23; 95% CrI, 0.043-0.86), and synbiotics (OR, 0.15; 95% CrI, 0.035-0.50) were associated with lower odds of mortality. Probiotics (MD, -2.3; 95% CrI: -3.7- -0.63) appeared to have earlier age of attainment of full feeding.

Conclusions: Based on this NMA, probiotics and synbiotics had the potential to be the top two preferable food supplements.

Keywords: Food supplements; Necrotizing enterocolitis; Network meta-analysis; Preterm neonates.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arginine
  • Enterocolitis, Necrotizing* / epidemiology
  • Enterocolitis, Necrotizing* / prevention & control
  • Glutamine
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases*
  • Infant, Premature
  • Lactoferrin
  • Network Meta-Analysis
  • Probiotics* / therapeutic use

Substances

  • Lactoferrin
  • Glutamine
  • Arginine