Mansfield Joseph A, Bergin Samuel W, Cooper James R, Olsen Cara H
F. Edward Hebert School of Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
Department of Preventative Medicine and Biometrics, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
Mil Med. 2014 Jun;179(6):580-92. doi: 10.7205/MILMED-D-13-00546.
Eczema affects 3.5% of the global population, with peak prevalence during infancy. Eczema has no cure, but probiotics have been suggested as a preventative measure.
To comprehensively analyze the impact of prenatal and postnatal probiotic supplementation on the prevention of infantile and childhood eczema.
MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and PubMed were searched for randomized controlled trials regarding probiotic usage and eczema development from 1945 to 2013. Participants included were 7 years old or younger with probiotic exposure in utero or below 6 months of age and who was not diagnosed previously.
27 publications describing 16 studies assessing 10 probiotics in 2,797 participants met our criterion. The pooled relative risk of all the studies, 0.74 (95% confidence interval 0.67, 0.82), indicated that probiotic supplementation in the first several years of life did have a significant impact on development of eczema. During evaluation of the studies, heterogeneity of terms and definitions for similar primary and secondary outcomes were identified.
The use of probiotic supplements during pregnancy and/or during infancy creates a statistically significant decline in the incidence of eczema. The heterogeneity of terms and definitions regarding eczema is the major limitation of these studies.
湿疹影响全球3.5%的人口，在婴儿期患病率达到峰值。湿疹无法治愈，但益生菌被认为是一种预防措施。
全面分析产前和产后补充益生菌对预防婴幼儿及儿童期湿疹的影响。
检索MEDLINE、EMBASE、Cochrane对照试验中心注册库和PubMed，查找1945年至2013年期间关于益生菌使用与湿疹发生的随机对照试验。纳入的参与者年龄在7岁及以下，在子宫内接触过益生菌或年龄在6个月以下且此前未被诊断出患有湿疹。
27篇文献描述了16项研究，评估了2797名参与者中的10种益生菌，符合我们的标准。所有研究的合并相对风险为0.74（95%置信区间0.67, 0.82），表明在生命的最初几年补充益生菌对湿疹的发生有显著影响。在评估这些研究时，发现了类似主要和次要结局的术语和定义存在异质性。
孕期和/或婴儿期使用益生菌补充剂可使湿疹发病率在统计学上显著下降。关于湿疹的术语和定义的异质性是这些研究的主要局限性。
