Probiotic LGG reduces the risk of necrotizing enterocolitis in preterm infants, study finds
In a recent study published in the European Journal of Clinical Nutrition, a group of researchers assessed the strain-specific effects of LGG in preterm infants through a systematic review and meta-analysis of randomised controlled trials (RCTs) and non-RCTs.
Probiotics, which are live microorganisms offering health benefits, have been shown to reduce the risk of NEC (a serious intestinal condition in preterm infants) at Stage II or higher, as well as lower the rates of all-cause mortality, late-onset sepsis (LOS), and time to reach full feeds (TFF) among preterm infants with very low birth weight (VLBW). However, challenges remain in determining the optimal strain, duration, dosage, and safety of probiotic use.
This study followed the Cochrane methodology and the PRISMA 2020 guidelines for systematic reviews. It included both RCTs and non-RCTs published up to December 2023, focusing on preterm infants born before 37 weeks of gestation or weighing less than 2,500 grams. The intervention was central administration of LGG ATCC 53103 alone or with other probiotics, starting within the first ten days of life for at least seven days, compared to a placebo or control.
This study search yielded 1,435 potentially relevant citations. After removing 995 duplicates and excluding 331 studies that did not meet the inclusion criteria, 24 RCTs and eight non-RCTs were included in the analysis. Among the RCTs, 11 investigated single-strain LGG, while the remaining 13 examined multi-strain probiotics.
The systematic review of RCTs found that single-strain LGG significantly reduces the incidence of NEC in preterm infants but does not affect other outcomes. In contrast, multi-strain probiotics containing LGG were associated with benefits in reducing NEC, mortality, late-onset sepsis (LOS), and hospital stay duration.
References: Ananthan, A., Balasubramanian, H., Rath, C. et al. (2024) Lactobacillus rhamnosus GG as a probiotic for preterm infants: a strain specific systematic review and meta-analysis. Eur J Clin Nutr. doi: https://doi.org/10.1038/s41430-024-01474-0. https://www.nature.com/articles/s41430-024-01474-0
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