Rao Shripada, Srinivasjois Ravisha, Patole Sanjay
Department of Neonatal Pediatrics, Princess Margaret Hospital for Children, Roberts Road, Subiaco, Perth, Western Australia 6008, Australia.
Arch Pediatr Adolesc Med. 2009 Aug;163(8):755-64. doi: 10.1001/archpediatrics.2009.94.
To systematically review randomized controlled trials evaluating the efficacy and safety of prebiotic supplementation in full-term neonates.
Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and CINAHL databases and proceedings of relevant conferences.
Eleven of 24 identified trials (n = 1459) were eligible for inclusion. Intervention Trials comparing formula milk supplemented with or without prebiotics, commenced at or before age 28 days and continued for 2 weeks or longer.
Stool colony counts (bifidobacteria, lactobacilli, and pathogens), pH, consistency, frequency, anthropometry, and symptoms of intolerance.
Six trials reported significant increases and 2 reported a trend toward increases in bifidobacteria counts after supplementation. Meta-analysis estimated significant reduction in stool pH in infants who received prebiotic supplementation (weighted mean difference, -0.65; 95% confidence interval, -0.76 to -0.54; 6 trials). Infants who receive a supplement had slightly better weight gain than did controls (weighted mean difference, 1.07 g; 95% confidence interval, 0.14-1.99; 4 trials) with softer and frequent stools similar to breastfed infants. All but 1 trial reported that prebiotic supplementation was well tolerated. In that trial, diarrhea (18% vs 4%; P = .008), irritability (16% vs 4%; P = .03), and eczema (18% vs 7%; P = .046) were reported more frequently by parents of infants who received prebiotic supplements.
Prebiotic-supplemented formula is well tolerated by full-term infants. It increases stool colony counts of bifidobacteria and lactobacilli and results in stools similar to those of breastfed neonates without affecting weight gain. Larger trials with long-term follow-up are needed to determine whether these short-term benefits are sustained.
系统评价评估益生元补充剂对足月儿有效性和安全性的随机对照试验。
Cochrane对照试验中央登记库、MEDLINE、EMBASE、CINAHL数据库以及相关会议论文集。
24项已识别试验中的11项（n = 1459）符合纳入标准。干预试验比较了添加或未添加益生元的配方奶，试验在出生28天及以前开始，持续2周或更长时间。
粪便菌落计数（双歧杆菌、乳酸杆菌和病原体）、pH值、性状、频率、人体测量指标以及不耐受症状。
6项试验报告补充益生元后双歧杆菌计数显著增加，2项试验报告有增加趋势。荟萃分析估计，接受益生元补充剂的婴儿粪便pH值显著降低（加权平均差，-0.65；95%置信区间，-0.76至-0.54；6项试验）。接受补充剂的婴儿体重增加略优于对照组（加权平均差，1.07 g；95%置信区间，0.14 - 1.99；4项试验），粪便更软且排便频率更高，类似于母乳喂养的婴儿。除1项试验外，所有试验均报告益生元补充剂耐受性良好。在该试验中，接受益生元补充剂的婴儿家长报告腹泻（18%对4%；P = 0.008）、易怒（16%对4%；P = 0.03）和湿疹（18%对7%；P = 0.046）的发生率更高。
足月儿对添加益生元的配方奶耐受性良好。它可增加粪便中双歧杆菌和乳酸杆菌的菌落计数，使粪便与母乳喂养的新生儿相似，且不影响体重增加。需要进行更大规模的长期随访试验，以确定这些短期益处是否能持续。
