SynthesisBMJ open2017
Benefits of probiotics in preterm neonates in low-income and medium-income countries: a systematic review of randomised controlled trials.
Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 9 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- The effectiveness of treatment with probiotics in preventing necrotizing enterocolitis and related mortality: results from an umbrella meta-analysis on meta-analyses of randomized controlled trials.BMC gastroenterology · 2025Pooled it
- Prevention and Treatment of Neonatal Infections in Facility and Community Settings of Low- and Middle-Income Countries: A Descriptive Review.Neonatology · 2025Pooled it
- Probiotics for preventing neonatal sepsis in preterm neonates: a systematic review and meta-analysis for clinical practice.Epidemiology and health · 2025Pooled it
- Probiotics for the prevention of mortality and sepsis in preterm very low birth weight neonates from low- and middle-income countries: a Bayesian network meta-analysis.Frontiers in nutrition · 2023Pooled it
- Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review.Journal of global health · 2021Pooled it
- Probiotics for Preterm Infants in India - Systematic Review and Meta-Analysis of Randomized Controlled Trials.Indian journal of pediatrics · 2020Pooled it
- Probiotics Reduce Mortality and Morbidity in Preterm, Low-Birth-Weight Infants: A Systematic Review and Network Meta-analysis of Randomized Trials.Gastroenterology · 2020Pooled it
- Probiotic Supplementation During the Perinatal and Infant Period: Effects on Gut Dysbiosis and Disease.Nutrients · 2020Pooled it
- Choosing an appropriate probiotic product for your patient: An evidence-based practical guide.PloS one · 2018Pooled it
- Neonatal administration ofmSphere · 2025Trial
- Phentolamine and B vitamins for feeding intolerance in late preterm infants: a randomised trial.Asia Pacific journal of clinical nutrition · 2024Trial
- Effect of a Multi-Strain Probiotic on the Incidence and Severity of Necrotizing Enterocolitis and Feeding Intolerances in Preterm Neonates.Nutrients · 2022Trial
- Feasibility, Safety, and Impact of the Probiotics Lactiplantibacillus plantarum and Bifidobacterium longum subspecies infantis in Papua New Guinean Infants: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2025Article
- Association of antenatal dexamethasone administration timing with outcomes in preterm infants in a low- and middle-income country.Frontiers in medicine · 2025Article
- Unlocking the potential for microbiome-based therapeutics to address the sustainable development goal of good health and wellbeing.Microbial biotechnology · 2024Review
- Article
- Evidences and perspectives on the association between gut microbiota and sepsis: A bibliometric analysis from 2003 to 2023.Heliyon · 2024Article
- Effectiveness of a probiotic combination on the neurodevelopment of the very premature infant.Scientific reports · 2023Article
- The impact of early-life antibiotics and probiotics on gut microbial ecology and infant health outcomes: a Pregnancy and Birth Cohort in Northwest China (PBCC) study protocol.BMC pediatrics · 2022Article
- Neonatal Sepsis-Newer Insights.Indian journal of pediatrics · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAlthough there is an overall reduction in underfive mortality rate, the progress in reducing neonatal mortality rate has been very slow. Over the last 20 years, preterm births have steadily increased in low-income and medium-income countries (LMICs) particularly in sub-Saharan Africa and South Asia. Preterm birth is associated with increased mortality and morbidity, particularly in LMICs. Based on systematic reviews of randomised controlled trials (RCTs), many neonatal units in high-income countries have adopted probiotics as standard of care for preterm neonates. We aimed to systematically review the safety and efficacy of probiotics in reducing mortality and morbidity in preterm neonates in LMICs.
designSystematic review and meta-analysis of RCTs. DATA SOURCES: Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature and E-abstracts from Pediatric Academic Society meetings and other paediatric and neonatal conference proceedings were searched in January 2017. ELIGIBILITY CRITERIA: RCTs comparing probiotics versus placebo/no probiotic in preterm neonates (gestation<37 weeks) conducted in LMICs.
resultsTotal 23 (n=4783) RCTs from 4 continents and 10 LMICs were eligible for inclusion in the meta-analysis using fixed effect model. The risk of necrotising enterocolitis (NEC greater than or equal to stage II) (risk ratio (RR) 0.46 (95% CI 0.34 to 0.61), P<0.00001, numbers needed to treat (NNT) 25 (95% CI 20 to 50)), late-onset sepsis (LOS) (RR 0.80 (95% CI 0.71 to 0.91), P=0.0009, NNT 25 (95% CI 17 to 100)) and all-cause mortality (RR 0.73 (95% CI 0.59 to 0.90), P=0.003, NNT 50 (95% CI 25 to 100)) were significantly lower in probiotic supplemented neonates. The results were significant on random effects model analysis and after excluding studies with high risk of bias. No significant adverse effects were reported.
conclusionProbiotics have significant potential to reduce mortality and morbidity (eg, NEC, LOS) in preterm neonates in LMICs.
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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.