Probiotics Reduce Mortality and Morbidity in Preterm, Low-Birth-Weight Infants: A Systematic Review and Network Meta-analysis of Randomized Trials

Gastroenterology

Volumn 159, Issue 2, 2020, Pages 467-480

  Morgan, Rebecca L ^a   Preidis, Geoffrey A ^b   Kashyap, Purna C ^c   Weizman, Adam V ^d   Sadeghirad, Behnam ^a,e   Chang, Yaping ^f   Florez, Ivan D ^f   Foroutan, Farid ^f   Shahid, Shaneela ^f   Zeraatkar, Dena ^f  

^a MCMASTER UNIVERSITY   (Canada)

^b TEXAS CHILDREN S HOSPITAL   (United States)

^c MAYO CLINIC   (United States)

^d MOUNT SINAI HOSPITAL   (Canada)

^e MCMASTER UNIVERSITY   (Canada)

^f NONE

Author keywords

Commensal; Microbiota; Newborn; Supplement

Indexed keywords

PLACEBO; PROBIOTIC AGENT;

ALL CAUSE MORTALITY; ARTICLE; BIFIDOBACTERIUM ANIMALIS; CLINICAL OUTCOME; COMPARATIVE EFFECTIVENESS; DRUG EFFICACY; DRUG FORMULATION; HUMAN; LACTOBACILLUS REUTERI; LACTOBACILLUS RHAMNOSUS; LATE ONSET DISORDER; LENGTH OF STAY; LOW BIRTH WEIGHT; META ANALYSIS; NECROTIZING ENTEROCOLITIS; NETWORK META-ANALYSIS; NEWBORN; NEWBORN MORBIDITY; NEWBORN MORTALITY; NEWBORN SEPSIS; NONHUMAN; PREMATURITY; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); SACCHAROMYCES BOULARDII; SYSTEMATIC REVIEW; COMPARATIVE STUDY; INFANT; INFANT MORTALITY; INTESTINE FLORA; MICROBIOLOGY; PATHOPHYSIOLOGY; PHYSIOLOGY; TREATMENT OUTCOME;

ENTEROCOLITIS, NECROTIZING; GASTROINTESTINAL MICROBIOME; HUMANS; INFANT; INFANT MORTALITY; INFANT, LOW BIRTH WEIGHT; INFANT, NEWBORN; INFANT, PREMATURE; NEONATAL SEPSIS; NETWORK META-ANALYSIS; PROBIOTICS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; TREATMENT OUTCOME;

EID: 85089502319     PISSN: 00165085     EISSN: 15280012     Source Type: Journal    
DOI: 10.1053/j.gastro.2020.05.096     Document Type: Article

References (105)

1. Goldenberg, R.L., Culhane, J.F., Iams, J.D., et al. Epidemiology and causes of preterm birth. Lancet 371:9606 (2008), 75–84.
2. Martin, J.A., Osterman, M.J.K., Centers for Disease Control and Prevention. Preterm births – United States, 2006 and 2010. MMWR Suppl 62 (2013), 136–138.
3. Neu, J., Walker, W.A., Necrotizing enterocolitis. N Engl J Med 364 (2011), 255–264.
4. Frost, B.L., Modi, B.P., Jaksic, T., et al. New medical and surgical insights into neonatal necrotizing enterocolitis: a review. JAMA Pediatr 171 (2017), 83–88.
5. Food and Agriculture Organization of the United Nations, World Health Organization. Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. Published 2001, Available at: http://www.fao.org/tempref/docrep/fao/meeting/009/y6398e.pdf Accessed July 27, 2020.
6. Preidis, G.A., Versalovic, J., Targeting the human microbiome with antibiotics, probiotics, and prebiotics: gastroenterology enters the metagenomics era. Gastroenterology 136 (2009), 2015–2031.
7. Patel, R.M., Underwood, M.A., Probiotics and necrotizing enterocolitis. Semin Pediatr Surg 27 (2018), 39–46.
8. AlFaleh, K., Anabrees, J., Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev, 10(4), 2014, CD005496.
9. Sadeghirad, B., Florez, I.D., Chang, Y., et al. Comparative effectiveness of prophylactic therapies for necrotizing enterocolitis in preterm infants: protocol for a network meta-analysis of randomized trials. Int J Prev Med, 9, 2018, 83.
10. Sadeghirad, B., Florez, I.D., Morgan, R.L., et al. Probiotics, prebiotics, and synbiotics for prevention of mortality and morbidity in preterm infants: a systematic review and network meta-analysis of randomized trials. (March 18, 2019). Available at: http://dx.doi.org/10.2139/ssrn.3354688 Accessed, July 27, 2020.
11. Preidis, G.A., Weizman, A.V., Kashyap, P.C., et al. AGA technical review on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology 159 (2020), 708–738.
12. Bell, M.J., Ternberg, J.L., Feigin, R.D., et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 187 (1978), 1–7.
13. Walsh, M., Kliegman, R., Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am 33 (1986), 179–201.
14. Higgins, J.P.T., Altman, D.G., Gøtzsche, P.C., et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ, 343, 2011, d5928.
15. Akl, E.A., Sun, X., Busse, J.W., et al. Specific instructions for estimating unclearly reported blinding status in randomized trials were reliable and valid. J Clin Epidemiol 65 (2012), 262–267.
16. Higgins JPT, Green S, eds. Cochrane handbook for systematic reviews of interventions, version 5.1.0. The Cochrane Collaboration. Available at: www.handbook.cochrane.org. Updated March 2011. Accessed June 21, 2020.
17. Hozo, S.P., Djulbegovic, B., Hozo, I., Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 5, 2005, 13.
18. White, I.R., Network meta-analysis. Stata J 15 (2015), 951–985.
19. White, I.R., Barrett, J.K., Jackson, D., et al. Consistency and inconsistency in network meta-analysis: model estimation using multivariate meta-regression. Res Synth Methods 3 (2012), 111–125.
20. Chaimani, A., Salanti, G., Visualizing assumptions and results in network meta-analysis: the network graphs package. Stata J 15 (2015), 905–950.
21. Harbord, R.M., Egger, M., Sterne, J.A., A modified test for small-study effects in meta-analyses of controlled trials with binary endpoints. Stat Med 25 (2006), 3443–3457.
22. Higgins, J.P.T., Thompson, S.G., Deeks, J.J., et al. Measuring inconsistency in meta-analyses. BMJ 327 (2003), 557–560.
23. Lu, G., Ades, A.E., Assessing evidence inconsistency in mixed treatment comparisons. J Am Stat Assoc 101 (2006), 447–459.
24. Higgins, J.P., Jackson, D., Barrett, J.K., et al. Consistency and inconsistency in network meta-analysis: concepts and models for multi-arm studies. Res Synth Methods 3 (2012), 98–110.
25. Guyatt, G.H., Oxman, A.D., Vist, G.E., et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336 (2008), 924–926.
26. Puhan, M.A., Schunemann, H.J., Murad, M.H., et al. A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis. BMJ, 349, 2014, g5630.
27. Brignardello-Petersen, R., Bonner, A., Alexander, P.E., et al. Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis. J Clin Epidemiol 93 (2018), 36–44.
28. Li, Y., Shimizu, T., Hosaka, A., et al. Effects of Bifidobacterium breve supplementation on intestinal flora of low birth weight infants. Pediatr Int 46 (2004), 509–515.
29. Coleta, E., Gheonea, M., Sarbu, M., Oral supplementation with probiotics in premature infants-a randomised clinical trial. Intensive Care Med, 39, 2013, S113.
30. Koksal, N., Varal, I., Ozkan, H., et al. Effect of probiotic support on feeding intolerance and mortality at preterm infants. J Perinat Med, 43, 2015, 1035.
31. Kapiki, A., Costalos, C., Oikonomidou, C., et al. The effect of a fructo-oligosaccharide supplemented formula on gut flora of preterm infants. Early Hum Dev 83 (2007), 335–339.
32. Wang, C., Shoji, H., Sato, H., et al. Effects of oral administration of Bifidobacterium breve on fecal lactic acid and short-chain fatty acids in low birth weight infants. J Pediatr Gastroenterol Nutr 44 (2007), 252–257.
33. Zeber-Lubecka, N., Kulecka, M., Ambrozkiewicz, F., Effect of Saccharomyces boulardii and mode of delivery on the early development of the gut microbial community in preterm infants. PLoS One, 11(2), 2016, e0150306.
34. Indrio, F., Riezzo, G., Raimondi, F., et al. The effects of probiotics on feeding tolerance, bowel habits, and gastrointestinal motility in preterm newborns. J Pediatr 152 (2008), 801–806.
35. Partty, A., Luoto, R., Kalliomaki, M., et al. Effects of early prebiotic and probiotic supplementation on development of gut microbiota and fussing and crying in preterm infants: a randomized, double-blind, placebo-controlled trial. J Pediatr 163 (2013), 1272–1277.
36. Al-Hosni, M., Duenas, M., Hawk, M., et al. Probiotics-supplemented feeding in extremely low-birth-weight infants. J Perinatol 32 (2012), 253–259.
37. Arora, S., Khurana, M.S., Saini, R., To study the role of probiotics in the prevention of necrotizing enterocolitis in preterm neonates. Int J Contemp Pediatrics 4 (2017), 1792–1797.
38. Bin-Nun, A., Bromiker, R., Wilschanski, M., et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates. J Pediatr 147 (2005), 192–196.
39. Braga, T.D., da Silva, G.A.P., de Lira, P.I.C., de Carvalho Lima, M., Efficacy of Bifidobacterium breve and Lactobacillus casei oral supplementation on necrotizing enterocolitis in very-low-birth-weight preterm infants: a double-blind, randomized, controlled trial. Am J Clin Nutr 93 (2011), 81–86.
40. Chowdhury, T., Ali, M.M., Hossain, M.M., et al. Efficacy of probiotics versus placebo in the prevention of necrotizing enterocolitis in preterm very low birth weight infants: a double-blind randomized controlled trial. J Coll Physicians Surg Pak 26 (2016), 770–774.
41. Chrzanowska-Liszewska, D., Seliga-Siwecka, J., Kornacka, M.K., The effect of Lactobacillus rhamnosus GG supplemented enteral feeding on the microbiotic flora of preterm infants-double blinded randomized control trial. Early Hum Dev 88 (2012), 57–60.
42. Costalos, C., Skouteri, V., Gounaris, A., et al. Enteral feeding of premature infants with Saccharomyces boulardii. Early Hum Dev 74 (2003), 89–96.
43. Costeloe, K., Hardy, P., Juszczak, E., et al. Bifidobacterium breve BBG-001 in very preterm infants: a randomised controlled phase 3 trial. Lancet 387:10019 (2016), 649–660.
44. Dani, C., Biadaioli, R., Bertini, G., et al. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol Neonate 82 (2002), 103–108.
45. Dashti, A.S., Afjeh, S.A., Basiry, A., et al. Prophylactic probiotics for prevention of necrotizing enterocolitis (NEC) in low birth weight neonates. Arch Pediatr Infect Dis 2 (2014), 174–179.
46. Demirel, G., Erdeve, O., Celik, I.H., et al. Saccharomyces boulardii for prevention of necrotizing enterocolitis in preterm infants: a randomized, controlled study. Acta Paediatr 102:12 (2013), e560–e565.
47. Deng, J., Chen, K., Early minimal feeding combined with probiotics to prevent necrotizing enterocolitis in preterm infant. Chin J Modern Drug Appl 4 (2010), 13–14.
48. Di, M., Li, X., Effects of Bifidobacterium supplementation for prevention of necrotizing enterocolitis in preterm infants: a randomized, controlled trial. Zhong Guo She Qu Yi Shi, 231, 2010, 69.
49. Dilli, D., Aydin, B., Fettah, N.D., et al. The ProPre-Save Study: effects of probiotics and prebiotics alone or combined on necrotizing enterocolitis in very low birth weight infants. J Pediatr 166 (2015), 545–551.
50. Dongol Singh, S., Klobassa, D., Resch, B., et al. Placebo controlled introduction of prophylactic supplementation of probiotics to decrease the incidence of necrotizing enterocolitis at Dhulikhel Hospital in Nepal. Kathmandu Univ Med J 60 (2017), 319–323.
51. Dutta, S., Ray, P., Narang, A., comparison of stool colonization in premature infants by three dose regimes of a probiotic combination: a randomized controlled trial. Am J Perinatol 32 (2015), 733–740.
52. Fernández-Carrocera, L.A., Solis-Herrera, A., Cabanillas-Ayón, M., et al. Double-blind, randomised clinical assay to evaluate the efficacy of probiotics in preterm newborns weighing less than 1500 g in the prevention of necrotising enterocolitis. Arch Dis Child Fetal Neonatal Ed 98 (2013), F5–F9.
53. Fujii, T., Ohtsuka, Y., Lee, T., et al. Bifidobacterium breve enhances transforming growth factor β1 signaling by regulating Smad7 expression in preterm infants. J Pediatr Gastroenterol Nutr 43 (2006), 83–88.
54. Hariharan, D., Balasubramanian, L., Kannappan, V., Veluswami, G., Probiotic supplementation in VLBW preterm infants improves feeding tolerance and reduces risk of gram negative sepsis. J Pediatr Gastroenterol Nutr, 62, 2016, 655.
55. Hays, S., Jacquot, A., Gauthier, H., et al. Probiotics and growth in preterm infants: a randomized controlled trial, PREMAPRO study. Clin Nutr 35 (2016), 802–811.
56. Hernández-Enríquez, N.P., Rosas-Sumano, A.B., Monzoy-Ventre, M.A., Galicia-Flores, L., Lactobacillus reuteri DSM 17938 en la prevención de enterocolitis necrosante en recién nacidos prematuros. Estudio piloto de eficacia y seguridad. Rev Mex Pediatr 83 (2016), 37–43.
57. Hikaru, H., Koichi, K., Yayoi, Y., et al. Bifidobacteria prevents preterm infants from developing infection and sepsis. Int J Probiotics Prebiotics 5 (2010), 33–36.
58. Hua, X.T., Tang, J., Mu, D.Z., Effect of oral administration of probiotics on intestinal colonization with drug-resistant bacteria in preterm infants [Chinese]. Chin J Contemp Pediatr 16 (2014), 606–609.
59. Huang, B., Yang, H., Huang, X., Probiotics supplementation for prevention of necrotizing enterocolitis in very low-birth-weight neonates: a randomized, controlled trial. J Guangdong Med Coll 27 (2009), 37–39.
60. Indrio, F., Riezzo, G., Tafuri, S., et al. Probiotic supplementation in preterm: feeding intolerance and hospital cost. Nutrients, 9(9), 2017, 965.
61. Jacobs, S.E., Tobin, J.M., Opie, G.F., et al. Probiotic effects on late-onset sepsis in very preterm infants: a randomized controlled trial. Pediatrics 132 (2013), 1055–1062.
62. Kanic, Z., Micetic Turk, D., Burja, S., et al. Influence of a combination of probiotics on bacterial infections in very low birthweight newborns. Wien Klin Wochenschr 127 (2015), 210–215.
63. Ke, D., Su, Z., Li, L., Effects of bifido supplement for prevention of necrotizing enterocolitis in preterm infants: a randomized controlled trial. Chin Pediatr Emerg Med 12 (2008), 69–71.
64. Kitajima, H., Sumida, Y., Tanaka, R., et al. Early administration of Bifidobacterium breve to preterm infants: randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 76:2 (1997), F101–F107.
65. Lin, H.C., Hsu, C.H., Chen, H.L., et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics 122 (2008), 693–700.
66. Lin, H.-C., Su, B.-H., Chen, A.-C., et al. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics 115 (2005), 1–4.
67. Manzoni, P., Meyer, M., Stolfi, I., et al. Bovine lactoferrin supplementation for prevention of necrotizing enterocolitis in very-low-birth-weight neonates: a randomized clinical trial. Early Hum Dev 90:Suppl 1 (2014), S60–S65.
68. Mihatsch, W.A., Vossbeck, S., Eikmanns, B., et al. Effect of Bifidobacterium lactis on the incidence of nosocomial infections in very-low-birth-weight infants: a randomized controlled trial. Neonatology 98 (2010), 156–163.
69. Millar, M.R., Bacon, C., Smith, S.L., et al. Enteral feeding of premature-infants with Lactobacillus GG. Arch Dis Child 69 (1993), 483–487.
70. Mohan, R., Koebnick, C., Schildt, J., et al. Effects of Bifidobacterium lactis Bb12 supplementation on body weight, fecal pH, acetate, lactate, calprotectin, and IgA in preterm infants. Pediatr Res 64 (2008), 418–422.
71. Oncel, M.Y., Sari, F.N., Arayici, S., et al. Lactobacillus reuteri for the prevention of necrotising enterocolitis in very low birthweight infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 99:2 (2014), F110–F115.
72. Patole, S., Keil, A.D., Chang, A., et al. Effect of Bifidobacterium breve M-16V supplementation on fecal bifidobacteria in preterm neonates - a randomised double blind placebo controlled trial. PLoS One, 9(3), 2014, e89511.
73. Punnahitananda, S., Thaithumyanon, P., Soongsawang, K., Nosocomial infection and necrotizing enterocolitis in preterm neonates treated with Lactobacillus acidophilus and Bifidobacterium infantis in a neonatal intensive care unit: a randomized controlled study. Paper presented at: 14th Congress of the Federation of Asia Oceania Perinatal Societies; October 1-5, 2006 Bangkok, Thailand, 2006.
74. Qiao, L.X., Zhu, W.Y., Zhang, H.Y., et al. Effect of early administration of probiotics on gut microflora and feeding in pre-term infants: a randomized controlled trial. J Matern Fetal Neonatal Med 30 (2017), 13–16.
75. Ren, B., Preventive effect of Bifidobacterium tetravaccine tablets in premature infants with necrotizing enterocolitis. J Pediatr Pharm 16 (2010), 24–25.
76. Reuman, P.D., Duckworth, D.H., Smith, K.L., et al. Lack of effect of Lactobacillus on gastrointestinal bacterial colonization in premature infants. Pediatr Infect Dis 5 (1986), 663–668.
77. Rojas, M.A., Lozano, J.M., Rojas, M.X., et al. Prophylactic probiotics to prevent death and nosocomial infection in preterm infants. Pediatrics 130:5 (2012), e1113–e1120.
78. Romeo, M.G., Romeo, D.M., Trovato, L., et al. Role of probiotics in the prevention of the enteric colonization by Candida in preterm newborns: incidence of late-onset sepsis and neurological outcome. J Perinatol 31 (2011), 63–69.
79. Rouge, C., Piloquet, H., Butel, M.J., et al. Oral supplementation with probiotics in very-low-birth-weight preterm infants: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 89 (2009), 1828–1835.
80. Roy, A., Chaudhuri, J., Sarkar, D., et al. Role of enteric supplementation of probiotics on late-onset sepsis by Candida species in preterm low birth weight neonates: a randomized, double blind, placebo-controlled trial. N Am J Med Sci 6 (2014), 50–57.
81. Sadowska-Krawczenko, I., Korbal, P., Polak, A., et al. Lactobacillus rhamnosus ATC A07FA for preventing necrotizing enterocolitis in very-low-birth-weight preterm infants: a randomized controlled trial (preliminary results) [Polish]. Pediatr Pol 87 (2012), 139–145.
82. Saengtawesin, V., Tangpolkaiwalsak, R., Kanjanapattankul, W., Effect of oral probiotics supplementation in the prevention of necrotizing enterocolitis among very low birth weight preterm infants. J Med Assoc Thai 97:Suppl 6 (2014), S20–S25.
83. Samanta, M., Sarkar, M., Ghosh, P., et al. Prophylactic probiotics for prevention of necrotizing enterocolitis in very low birth weight newborns. J Trop Pediatr 55 (2009), 128–131.
84. Sari, F.N., Dizdar, E.A., Oguz, S., et al. Oral probiotics: Lactobacillus sporogenes for prevention of necrotizing enterocolitis in very low-birth weight infants: a randomized, controlled trial. Eur J Clin Nutr 65 (2011), 434–439.
85. Serce, O., Benzer, D., Gursoy, T., et al. Efficacy of Saccharomyces boulardii on necrotizing enterocolitis or sepsis in very low birth weight infants: a randomised controlled trial. Early Hum Dev 89 (2013), 1033–1036.
86. Shadkam, M.N., Jalalizadeh, F., Nasiriani, K., Effects of probiotic Lactobacillus reuteri (DSM 17938) on the incidence of necrotizing enterocolitis in very low birth weight premature infants. Iran J Neonatol 6 (2015), 15–20.
87. Shashidhar, A., Suman Rao, P.N., Nesargi, S., et al. Probiotics for promoting feed tolerance in very low birth weight neonates - a randomized controlled trial. Indian Pediatr 54 (2017), 363–367.
88. Sinha, A., Gupta, S.S., Chellani, H., et al. Role of probiotics VSL#3 in prevention of suspected sepsis in low birthweight infants in India: a randomised controlled trial. BMJ Open, 5(7), 2015, e006564.
89. Stratiki, Z., Costalos, C., Sevastiadou, S., et al. The effect of a bifidobacter supplemented bovine milk on intestinal permeability of preterm infants. Early Hum Dev 83 (2007), 575–579.
90. Tewari, V.V., Dubey, S.K., Gupta, G., Bacillus clausii for prevention of late-onset sepsis in preterm infants: a randomized controlled trial. J Trop Pediatr 61 (2015), 377–384.
91. Totsu, S., Yamasaki, C., Terahara, M., et al. Bifidobacterium and enteral feeding in preterm infants: cluster-randomized trial. Pediatr Int 56 (2014), 714–719.
92. Van Niekerk, E., Kirsten, G.F., Nel, D.G., Blaauw, R., Probiotics, feeding tolerance, and growth: a comparison between HIV-exposed and unexposed very low birth weight infants. Nutrition 30 (2014), 645–653.
93. Van Niekerk, E., Nel, D.G., Blaauw, R., Kirsten, G.F., Probiotics reduce necrotizing enterocolitis severity in HIV-exposed premature infants. J Trop Pediatr 61 (2015), 155–164.
94. Wejryd, E., Marchini, G., Frimmel, V., et al. Probiotics promoted head growth in extremely low birthweight infants in a double-blind placebo-controlled trial. Acta Paediatr 108 (2019), 62–69.
95. Xiao-yuan, Z., Lian-qiao, L.I., Xuan-xuan, G.A.O., Li-duan, S.U., Relative factors of neonatal necrotizing enterocolitis and preventive effect of microeco-preparation. J Appl Clin Pediatr 22 (2007), 1392–1393.
96. Xu, L., Wang, Y., Fu, J., et al. A double-blinded randomized trial on growth and feeding tolerance with Saccharomyces boulardii CNCM I-745 in formula-fed preterm infants. J Pediatr (Rio J) 92 (2016), 296–301.
97. Yang, S., Haiying, Y., Bin, G., et al. The clinical application value of endangered preterm infants given earlier amounts of micro feedings and adding probiotics. J Pediatr Pharm 17 (2011), 21–24.
98. Zhou, N., The observation of effect of probiotics in the prevention of neonatal necrotizing enterocolitis. Chin J Ethnomed Ethnopharm, 21, 2012, 81.
99. Kantorowska, A., Wei, J.C., Cohen, R.S., et al. Impact of donor milk availability on breast milk use and necrotizing enterocolitis rates. Pediatrics, 137(3), 2016, e20153123.
100. Athalye-Jape, G., Rao, S., Patole, S., Lactobacillus reuteri DSM 17938 as a probiotic for preterm neonates: a strain-specific systematic review. J Parenter Enteral Nutr 40 (2016), 783–794.
101. Athalye-Jape, G., Rao, S., Simmer, K., et al. Bifidobacterium breve M-16V as a probiotic for preterm infants: a strain-specific systematic review. J Parenter Enteral Nutr 42 (2018), 677–688.
102. van den Akker, C.H.P., van Goudoever, J.B., Szajewska, H., et al. Probiotics for preterm infants: a strain-specific systematic review and network meta-analysis. J Pediatr Gastroenterol Nutr 67 (2018), 103–122.
103. Deshpande, G., Jape, G., Rao, S., et al. Benefits of probiotics in preterm neonates in low-income and medium-income countries: a systematic review of randomised controlled trials. BMJ Open, 7(12), 2017, e017638.
104. Bafeta, A., Koh, M., Riveros, C., et al. Harms reporting in randomized controlled trials of interventions aimed at modifying microbiota: a systematic review. Ann Intern Med 169 (2018), 240–247.
105. Vallabhaneni, S., Walker, T.A., Lockhart, S.R., et al. Fatal gastrointestinal mucormycosis in a premature infant associated with a contaminated dietary supplement—Connecticut, 2014. MMWR Morb Mortal Wkly Rep 64:6 (2015), 155–156.