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2017 ; 96
(21
): e6652
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Preventing necrotizing enterocolitis by food additives in neonates: A network
meta-analysis revealing the efficacy and safety
#MMPMID28538366
Yu W
; Sui W
; Mu L
; Yi W
; Li H
; Wei L
; Yin W
Medicine (Baltimore)
2017[May]; 96
(21
): e6652
PMID28538366
show ga
BACKGROUND: Necrotizing enterocolitis (NEC) is a serious multifactorial
gastrointestinal disease which is often discovered in premature infants. Various
additives have been used to prevent NEC; yet, their relative efficacy and safety
remain disputed. This study aims to compare the efficacy and safety of 5 food
additives, namely, probiotics, probiotics?+?fructo-oligosaccharides,
pentoxifylline, arginine, and lactoferrin in preventing NEC in neonates. METHODS:
Embase, PubMed, and Cochrane Library had been searched for all eligible
randomized control trials. Odds ratios (ORs) were estimated for dichotomous data
and mean differences with 95% credible intervals (CrIs) were estimated for
continuous data. Surface under the cumulative ranking curve was used to rank
efficacy and safety of the prevention methods on each endpoint. RESULTS: A total
of 27 eligible studies with 4649 preterm infants were included in this network
meta-analysis (NMA), and the efficacy and safety of 5 food additives were
evaluated. Probiotic and arginine exhibited better preventive efficacy compared
with placebo (OR?=?0.50, 95% CrIs: 0.32-0.73; OR?=?0.30, 95% CrIs: 0.12-0.73,
respectively). Only probiotic achieved a considerable decrease in the risk of
mortality compared to placebo (OR?=?0.68, 95% CrIs: 0.46-0.98). NEC patients with
lactoferrin appeared to have lower incidence of sepsis than those of placebo
(OR?=?0.13, 95% CrIs: 0.03-0.61) or probiotic (OR?=?0.18, 95% CrIs: 0.03-0.83).
CONCLUSION: Based on this NMA, probiotics had the potential to be the most
preferable additive, since it exhibited a significant superiority for NEC and
mortality as well as a relatively balanced performance in safety.
|Enterocolitis, Necrotizing/*diet therapy/*prevention & control
[MESH]