Necrotizing enterocolitis (NEC) and nosocomial sepsis contribute significantly to the incidence and mortality of premature infants. By preventing the entry of bacteria through the intestinal mucosa, by competitively displacing pathogenic bacteria and by increasing the immune response, probiotics can play an important role in reducing the incidence of NEC and concomitant mortality.

The purpose of the meta-analysis by K. Alfaleh et al. (Saudi Arabia), this was a comparative evaluation of the efficacy and safety of probiotics compared to placebo and the absence of intervention in the prevention of severe NEC and / or sepsis in premature babies.

The study authors selected randomized or partially randomized controlled trials including premature infants (gestation period less than 37 weeks and / or body weight at birth less than 2500 g) who received probiotics with one of the results clinics listed in the MEDLINE (1966 to December 2006), EMBASE (1980 to December 2006), Cochrane Library Controlled Trials Register, as well as summaries of the annual conferences of the Society for Research in Pediatrics (1995-2006 ).

A total of 9 studies were selected, of which 1,425 were premature. The criteria for including patients in the study (gestational period, birth weight, etc.), the risk of developing NEC when the study started in the control groups, the time of admission, the doses and dosage forms of probiotics, as well as the children's diet, varied considerably in different studies. A meta-analysis by the authors of the work showed that taking probiotics led to a significant decrease in the incidence of severe NEC (stage II or more) (relative risk (RR) 0.32; confidence interval (CI) 95% 0.17-0.6) and mortality (RR 0.43; 95% CI 0.25-0.75). At the same time, the administration of probiotics was not accompanied by a significant reduction in the incidence of nosocomial sepsis (RR 0.93; 95% CI 0.73-1.19) and time spent on fully parenteral nutrition (weighted average difference -1.9; 95% CI -4.6 - 0.77). In the studies analyzed, no episode of development of systemic infections caused by any of the probiotic microorganisms was recorded.

Thus, the use of probiotics has led to a significant reduction in the risk of developing severe NEC and mortality in premature babies. Due to the lack of data, the authors of the work were unable to assess the efficacy and safety of the use of probiotics in neonates with an extremely small body weight (less than 1000 g ) at birth, which indicates the need for additional randomized controlled trials in this patient category.