Hi, my name is Ayushi Doshi. I'm currently an OMS 4 at Rowan Virchia School of Osteopathic Medicine, and this is Exploring the Use of Prophylactic Probiotics on Necrotizing Enterocolitis in Preterm Infants, a Systematic Review and Pooled Analysis. So while the incidence of necrotizing enterocolitis, otherwise NEC, has remained variable over the past few decades, it has continued to persist as a significant life-threatening disease in preterm infants. What is NEC? NEC is the necrotizing and hemorrhagic inflammation of the bowel wall, and the pathogenesis is quite considered microfactorial, with associated increased risk of prematurity, early enteral feeds, and low birth weight. Currently, literature suggests that the gut microbiome dysgenesis is linked to NEC, but further research is indicated to understand this better. Probiotics, which are therapeutic live bacterial supplements, are emerging as a potential modality for the treatment and prevention of NEC, and this does so by promoting, balancing, and enhancing the natal gut microbiome. The use of probiotics in the potential prevention and treatment of NEC can also be considered a holistic approach to gut microbiome pathology, consistent with our osteopathic principles. Thus, the objective of this research is to evaluate the efficacy of prophylactic probiotics in reducing the incidence and severity of NEC in preterm infants. A search query of published literature was conducted using PubMed, Embase, and Scopus, with articles dating from 2009 to May 2024. Study types selected were randomized control trials and cohort studies. Inclusion criteria consisted of studies that assess the administration of prophylactic probiotics to any category of preterm infants below 36 weeks. An analysis was conducted, and eventually an odds ratio was performed comparing the incidence of NEC in preterm neonates with exposure to prophylactic probiotics compared to those without. Of these studies, nine met the inclusion criteria, encompassing a total of 10,289 participants. Of the group, 184 preterm infants who received prophylactic probiotics versus 409 who did not receive probiotics experienced NEC. A meta-analysis computation yielded an odds ratio of 0.65 with a confidence interval of 0.53 to 0.80, favoring decreased odds of NEC with exposure to prophylactic probiotics. Thus, preterm infants who are administered these probiotics ultimately experience a decreased odds of NEC compared to those who did not. Thus, these findings support the integration of probiotic supplementation as prophylactics into standard neonatal care practices for preterm infants. This is potentially secondary to the modulation of the gut microbiome because it enhances the development of the innate mature immune system of preterm infants. However, the need to consider the variability in strain types, appropriate dosages, and ultimately external environmental exposures all warrant additional research efforts to ultimately identify the best and most optimal strain and dosing for therapeutic effect. Thank you.

prophylactic probiotics

necrotizing enterocolitis

preterm infants

meta-analysis

neonatal care