Background: 

Development of necrotizing enterocolitis is multifactorial, with contributing factors that are unique to the preterm infant in the neonatal intensive care unit (NICU). The use of probiotics may reduce these risk factors.

Purpose: 

To evaluate evidence of biologic plausibility for probiotic supplementation to mitigate key risk factors implicated in the development of disease and show recent evidence of safety and effectiveness.

Data Sources: 

A literature survey of electronic databases, including PubMed, Cochrane Database of Systematic Reviews, and CINAHL, was conducted.

Study Selection: 

Selection terms included “necrotizing enterocolitis,” “probiotics,” and “prematurity.” Reviews that were included were full text, in English, and published in the last 5 years. Ten systematic reviews of randomized controlled trials were extracted from 749 records. Excluded were studies that used adjuncts to probiotics, such as lactoferrin or prebiotics, and studies of probiotics given antenatally.

Data Extraction: 

Two independent reviewers extracted data to AMSTAR 2, a critical appraisal tool for systematic reviews of randomized or nonrandomized studies of healthcare interventions.

Results: 

All the reviews found statistically significant reductions in necrotizing enterocolitis rates after supplementation with probiotics. None of the reviews reported adverse effects.

Implication for Practice and Research: 

Probiotic supplementation with specific strains reduces risk for necrotizing enterocolitis. To advance probiotic use in the NICU, additional high-quality trials are needed to focus on specific strains or combinations of strains and to evaluate dosing and duration of treatment.

Video Abstract available athttps://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx.

中文翻译：

---

减少坏死性小肠结肠炎的危险因素：支持益生菌的最新证据和生物学合理性是什么？

背景： 

坏死性小肠结肠炎的发生是多因素的，其中一些因素是新生儿重症监护病房 (NICU) 中的早产儿所特有的。使用益生菌可以减少这些危险因素。

目的： 

评估补充益生菌以减轻与疾病发展有关的关键风险因素的生物学合理性证据，并展示最新的安全性和有效性证据。

数据源： 

对电子数据库（包括 PubMed、Cochrane 系统评价数据库和 CINAHL）进行了文献调查。

研究选择： 

选择术语包括“坏死性小肠结肠炎”、“益生菌”和“早产”。所包含的评论是全文，英文，并在过去 5 年发表。从 749 份记录中提取了 10 份随机对照试验的系统评价。排除使用益生菌辅助剂（例如乳铁蛋白或益生元）的研究，以及产前给予益生菌的研究。

数据提取： 

两名独立评审员将数据提取到 AMSTAR 2，这是一种重要的评估工具，用于对医疗干预的随机或非随机研究进行系统评审。

结果： 

所有的评论都发现，补充益生菌后，坏死性小肠结肠炎的发病率在统计上显着降低。没有任何评论报告不良反应。

对实践和研究的启示： 

补充特定菌株的益生菌可降低坏死性小肠结肠炎的风险。为了推进新生儿重症监护室中益生菌的使用，需要额外的高质量试验来关注特定菌株或菌株组合，并评估剂量和治疗持续时间。

视频摘要可在https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx获取。