SynthesisBMJ (Clinical research ed.)2013
Probiotic supplementation during pregnancy or infancy for the prevention of asthma and wheeze: systematic review and meta-analysis.
Synthesis in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 87 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Recurrent Wheezing in Infants: Risk Factors and Prevention With Probiotics, a Randomized Clinical Trial, Double-blind, Placebo Controlled.
Randomized, Placebo-controlled, Multicenter Study to Assess the Efficacy, Safety and Tolerability of ORal Bacterial EXtract for the Prevention of Wheezing Lower Respiratory Tract Illness (ORBEX)
Who cites it
87 citing papers in PubMed, 9 syntheses or guidelines pooled it, 202 citations in OpenAlex.
- Probiotic Supplementation and Its Impact on Atopic Dermatitis and Related Conditions in Infants and Children: An Umbrella Review of Systematic Reviews with Meta-Analyses.Probiotics and antimicrobial proteins · 2026Pooled it
- The association between early-life respiratory infections and childhood asthma: a meta-analytic perspective.Frontiers in medicine · 2026Pooled it
- A network meta-analysis ofFrontiers in pediatrics · 2025Pooled it
- Effects of probiotics on the prevention and treatment of children with allergic rhinitis: a meta-analysis of randomized controlled trials.Frontiers in pediatrics · 2024Pooled it
- Postnatal probiotic supplementation can prevent and optimize treatment of childhood asthma and atopic disorders: A systematic review of randomized controlled trials.Frontiers in pediatrics · 2022Pooled it
- Impact of Maternal Nutritional Supplementation during Pregnancy and Lactation on the Infant Gut or Breastmilk Microbiota: A Systematic Review.Nutrients · 2021Pooled it
- Bacterial lysate therapy for the prevention of wheezing episodes and asthma exacerbations: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2020Pooled it
- Dietary factors during pregnancy and atopic outcomes in childhood: A systematic review from the European Academy of Allergy and Clinical Immunology.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2020Pooled it
- Probiotic supplementation during pregnancy or infancy for the prevention of asthma and wheeze: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2013Pooled it
- Study protocol: evaluation of the probiotic Lactobacillus Fermentum CECT5716 for the prevention of mastitis in breastfeeding women: a randomised controlled trial.BMC pregnancy and childbirth · 2017Trial
- Effect of probiotics on digestibility and immunity in infants: A study protocol for a randomized controlled trial.Medicine · 2017Trial
- Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial.BMC dermatology · 2015Trial
- Evidence-based guideline for clinical practice in the diagnosis, treatment, management, and prevention of recurrent wheezing in infants and toddlers in China.Pediatric investigation · 2026Article
- From gut microbiota dysbiosis to immune dysregulation: pathogenic mechanisms and emerging therapeutic perspectives in pediatric asthma.Frontiers in immunology · 2026Review
- The role of the early-life gut microbiome in childhood asthma.Gut microbes · 2025Review
- Gut Health for Two: the Critical Role of Probiotics and Prebiotics in Pregnancy and Lactation.Current nutrition reports · 2025Review
- Oral microbiota and respiratory diseases: advances and perspectives.Clinical microbiology reviews · 2025Review
- Prenatal exposure to endocrine-disrupting chemicals and childhood atopic dermatitis: epidemiological evidence.Frontiers in microbiology · 2025Review
- COPD Treatment with Beta 2-Adrenoreceptor Agonists: Medicinal Perspectives and Recent Advances.Mini reviews in medicinal chemistry · 2025Review
- Non-pharmacological interventions for asthma prevention and management across the life course: Umbrella review.Clinical and translational allergy · 2024Review
27 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveTo evaluate the association of probiotic supplementation during pregnancy or infancy with childhood asthma and wheeze.
designSystematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Embase, and Central (Cochrane Library) databases from inception to August 2013, plus the World Health Organization's international clinical trials registry platform and relevant conference proceedings for the preceding five years. Included trials and relevant reviews were forward searched in Web of Science. REVIEW
methodsTwo reviewers independently identified randomised controlled trials evaluating probiotics administered to mothers during pregnancy or to infants during the first year of life. The primary outcome was doctor diagnosed asthma; secondary outcomes included wheeze and lower respiratory tract infection.
resultsWe identified 20 eligible trials including 4866 children. Trials were heterogeneous in the type and duration of probiotic supplementation, and duration of follow-up. Only five trials conducted follow-up beyond participants' age of 6 years (median 24 months), and none were powered to detect asthma as the primary outcome. The overall rate of doctor diagnosed asthma was 10.7%; overall rates of incident wheeze and lower respiratory tract infection were 33.3% and 13.9%, respectively. Among 3257 infants enrolled in nine trials contributing asthma data, the risk ratio of doctor diagnosed asthma in participants randomised to receive probiotics was 0.99 (95% confidence interval 0.81 to 1.21, I(2)=0%). The risk ratio of incident wheeze was 0.97 (0.87 to 1.09, I(2)=0%, 9 trials, 1949 infants). Among 1364 infants enrolled in six trials, the risk ratio of lower respiratory tract infection after probiotic supplementation was 1.26 (0.99 to 1.61, I(2)=0%). We adjudicated most trials to be of high (ten trials) or unclear (nine trials) risk of bias, mainly due to attrition.
conclusionsWe found no evidence to support a protective association between perinatal use of probiotics and doctor diagnosed asthma or childhood wheeze. Randomised controlled trials to date have not yielded sufficient evidence to recommend probiotics for the primary prevention of these disorders. Extended follow-up of existing trials, along with further clinical and basic research, are needed to accurately define the role of probiotics in the prevention of childhood asthma. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42013004385).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.