Aslan Mustafa Törehan, Ersözlü Yasemin, Özen Metehan
Department of Neonatology, Koç University Hospital, 34010 Istanbul, Türkiye.
Department of Pediatric Infectious Disease, School of Medicine, Acibadem University, 34752 Istanbul, Türkiye.
Nutrients. 2025 May 29;17(11):1867. doi: 10.3390/nu17111867.
This study aimed to evaluate the supportive role of probiotic supplementation in neonatal weight gain through a meta-analysis of published studies. Given the conflicting results in the literature, the objective was to determine the overall effect size and assess the influence of regional and intervention-specific factors. A total of 20 studies published between 2011 and 2022 were included, comprising a combined sample size of 3929 neonates. A random-effects model was used to calculate the pooled standardized mean difference (SMD) in neonatal weight gain attributable to probiotic supplementation. Heterogeneity among studies was assessed using the statistic. Subgroup analyses were conducted based on geographic region, probiotic strain, dosage, and treatment duration. The pooled analysis demonstrated a modest but non-significant positive effect on neonatal weight gain (SMD: 0.27; 95% CI: -0.06 to 0.61), with substantial heterogeneity across studies ( = 91%). Subgroup analyses indicated that regional variations, particularly in studies conducted in China, were associated with a more favorable effect. However, not all studies reported a benefit; some found no difference or even negative effects, particularly in discharge weight outcomes. Probiotic supplementation shows potential for improving neonatal weight gain, but findings remain inconsistent and heterogeneous. Strain selection, dosage, and treatment duration appear to be critical variables influencing outcomes. Future large-scale, multicenter randomized controlled trials are necessary to develop standardized, evidence-based guidelines for probiotic use in neonatal care.
本研究旨在通过对已发表研究的荟萃分析，评估补充益生菌对新生儿体重增加的支持作用。鉴于文献中的结果相互矛盾，目标是确定总体效应大小，并评估区域和干预特定因素的影响。总共纳入了2011年至2022年间发表的20项研究，合并样本量为3929名新生儿。采用随机效应模型计算补充益生菌后新生儿体重增加的合并标准化平均差（SMD）。使用 统计量评估研究间的异质性。基于地理区域、益生菌菌株、剂量和治疗持续时间进行亚组分析。汇总分析显示，补充益生菌对新生儿体重增加有适度但不显著的积极影响（SMD：0.27；95%CI：-0.06至0.61），研究间存在显著异质性（ = 91%）。亚组分析表明，区域差异，特别是在中国进行的研究，与更有利的效果相关。然而，并非所有研究都报告了益处；一些研究发现没有差异甚至有负面影响，特别是在出院时的体重结果方面。补充益生菌显示出改善新生儿体重增加的潜力，但结果仍然不一致且存在异质性。菌株选择、剂量和治疗持续时间似乎是影响结果的关键变量。未来有必要开展大规模、多中心随机对照试验，以制定新生儿护理中益生菌使用的标准化、循证指南。
