Preventing necrotizing enterocolitis by food additives in neonates
| Autor: | Wentao Yu, Linsong Mu, Wu Sui, Weihong Yin, Liqin Wei, Wenying Yi, Haijuan Li |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Enterocolitis
medicine.medical_specialty business.industry General Medicine Odds ratio Cochrane Library medicine.disease Placebo law.invention 03 medical and health sciences Probiotic 0302 clinical medicine Randomized controlled trial law 030225 pediatrics Internal medicine Necrotizing enterocolitis medicine Risk of mortality 030212 general & internal medicine medicine.symptom Intensive care medicine business |
| Zdroj: | Medicine. 96:e6652 |
| ISSN: | 0025-7974 |
| DOI: | 10.1097/md.0000000000006652 |
| Popis: | Background Necrotizing enterocolitis (NEC) is a serious multifactorial gastrointestinal disease which is often discovered in premature infants. Various additives have been used to prevent NEC; yet, their relative efficacy and safety remain disputed. This study aims to compare the efficacy and safety of 5 food additives, namely, probiotics, probiotics + fructo-oligosaccharides, pentoxifylline, arginine, and lactoferrin in preventing NEC in neonates. Methods Embase, PubMed, and Cochrane Library had been searched for all eligible randomized control trials. Odds ratios (ORs) were estimated for dichotomous data and mean differences with 95% credible intervals (CrIs) were estimated for continuous data. Surface under the cumulative ranking curve was used to rank efficacy and safety of the prevention methods on each endpoint. Results A total of 27 eligible studies with 4649 preterm infants were included in this network meta-analysis (NMA), and the efficacy and safety of 5 food additives were evaluated. Probiotic and arginine exhibited better preventive efficacy compared with placebo (OR = 0.50, 95% CrIs: 0.32-0.73; OR = 0.30, 95% CrIs: 0.12-0.73, respectively). Only probiotic achieved a considerable decrease in the risk of mortality compared to placebo (OR = 0.68, 95% CrIs: 0.46-0.98). NEC patients with lactoferrin appeared to have lower incidence of sepsis than those of placebo (OR = 0.13, 95% CrIs: 0.03-0.61) or probiotic (OR = 0.18, 95% CrIs: 0.03-0.83). Conclusion Based on this NMA, probiotics had the potential to be the most preferable additive, since it exhibited a significant superiority for NEC and mortality as well as a relatively balanced performance in safety. |
| Databáze: | OpenAIRE |
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