Do Probiotics Reduce the Risk of All-Cause Mortality in Premature Babies?

Check out this answer from Consensus:

Probiotics appear to reduce the risk of all-cause mortality in preterm infants, with the most substantial evidence supporting the use of combinations of Lactobacillus spp. and Bifidobacterium spp. The findings are consistent across both randomized controlled trials and observational studies, although the benefits are less pronounced in extremely low birth weight infants. Additionally, probiotics help reduce the incidence of NEC and late-onset sepsis, further contributing to improved survival rates.

Probiotics have been studied extensively for their potential benefits in reducing various health complications in preterm infants, including necrotizing enterocolitis (NEC), sepsis, and overall mortality. This synthesis aims to evaluate whether probiotics reduce the risk of all-cause mortality in premature babies based on data from multiple research papers.

Key Insights

Reduction in All-Cause Mortality:
- Probiotics likely reduce all-cause mortality in preterm infants. Meta-analyses of randomized controlled trials (RCTs) and observational studies consistently show a significant reduction in mortality rates among preterm infants receiving probiotics compared to those who do not1 2 3 4 5 6 7.
Effectiveness of Specific Probiotic Strains:
- Combinations of Lactobacillus spp. and Bifidobacterium spp. are particularly effective in reducing all-cause mortality in preterm infants3 5. These combinations have shown moderate- to high-quality evidence of efficacy.
Consistency Across Study Types:
- Both RCTs and observational studies support the finding that probiotics reduce all-cause mortality in preterm infants. The effect sizes are similar across different study designs, indicating robust evidence2 4 6.
Impact on Extremely Low Birth Weight Infants:
- The benefits of probiotics in reducing mortality are less clear in extremely low birth weight (ELBW) infants. Some studies suggest a reduction in mortality, but the evidence is not as strong or consistent as it is for less extreme preterm infants2 8.
Additional Health Benefits:
- Probiotics also reduce the incidence of NEC and late-onset sepsis, which are significant contributors to mortality in preterm infants. This reduction in severe complications likely contributes to the overall decrease in mortality1 2 3 4 6 7 9.