{"title":"The best type of probiotic for the prevention and treatment of neonatal physiological jaundice: A systematic review and meta-analysis.","authors":"Behzad Barekatain, Zahra Asefi, Roya Kelishadi, Maryam Yazdi, Motahar Heidari-Beni","doi":"10.4103/jrms.jrms_746_25","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gut microbiota play an important role in bilirubin metabolism and may influence the course of neonatal physiological jaundice. This systematic review and meta-analysis aimed to evaluate the strain-specific efficacy of probiotics in the prevention and adjunctive treatment of neonatal physiological jaundice.</p><p><strong>Materials and methods: </strong>A comprehensive search of PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library, World Health Organization databases, and Persian databases (Scientific information database [SID] and Magiran) for studies published up to 2024 was conducted. Randomized controlled trials (RCTs) evaluating probiotics in term and late-preterm neonates (≥35 weeks) with physiological jaundice were included. Data extraction, quality assessment, and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using a random-effects model.</p><p><strong>Results: </strong>Nineteen RCTs (13 therapeutic and 6 prophylactic) were included. Prophylactic probiotic administration was associated with a reduced need for phototherapy (odds ratio [OR] =0.60; 95% confidence interval [CI]: 0.37-0.96). As an adjunct to phototherapy, probiotics were associated with lower bilirubin levels (mean difference [MD] = -1.61; 95% CI: -3.10--0.11), shorter phototherapy duration (~5 h), and reduced hospitalization (0.3 days). Reduction in bilirubin was more evident during the 2<sup>nd</sup> and 3<sup>rd</sup> days of treatment. Strain-specific differences were observed; <i>Clostridium butyricum</i> and <i>Lactobacillus reuteri</i> demonstrated larger pooled effect sizes for bilirubin reduction, whereas <i>Saccharomyces boulardii</i> showed greater protective effect against phototherapy.</p><p><strong>Conclusion: </strong>Probiotics may serve as beneficial adjuncts in the prevention and management of neonatal physiological jaundice, with potential strain-dependent differences. Given heterogeneity and limited data for some strains, findings should be interpreted cautiously. Further well-designed, adequately powered RCTs are warranted.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"31 ","pages":"21"},"PeriodicalIF":1.7000,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619108/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Research in Medical Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/jrms.jrms_746_25","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Gut microbiota play an important role in bilirubin metabolism and may influence the course of neonatal physiological jaundice. This systematic review and meta-analysis aimed to evaluate the strain-specific efficacy of probiotics in the prevention and adjunctive treatment of neonatal physiological jaundice.
Materials and methods: A comprehensive search of PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library, World Health Organization databases, and Persian databases (Scientific information database [SID] and Magiran) for studies published up to 2024 was conducted. Randomized controlled trials (RCTs) evaluating probiotics in term and late-preterm neonates (≥35 weeks) with physiological jaundice were included. Data extraction, quality assessment, and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using a random-effects model.
Results: Nineteen RCTs (13 therapeutic and 6 prophylactic) were included. Prophylactic probiotic administration was associated with a reduced need for phototherapy (odds ratio [OR] =0.60; 95% confidence interval [CI]: 0.37-0.96). As an adjunct to phototherapy, probiotics were associated with lower bilirubin levels (mean difference [MD] = -1.61; 95% CI: -3.10--0.11), shorter phototherapy duration (~5 h), and reduced hospitalization (0.3 days). Reduction in bilirubin was more evident during the 2nd and 3rd days of treatment. Strain-specific differences were observed; Clostridium butyricum and Lactobacillus reuteri demonstrated larger pooled effect sizes for bilirubin reduction, whereas Saccharomyces boulardii showed greater protective effect against phototherapy.
Conclusion: Probiotics may serve as beneficial adjuncts in the prevention and management of neonatal physiological jaundice, with potential strain-dependent differences. Given heterogeneity and limited data for some strains, findings should be interpreted cautiously. Further well-designed, adequately powered RCTs are warranted.
期刊介绍：
Journal of Research in Medical Sciences, a publication of Isfahan University of Medical Sciences, is a peer-reviewed online continuous journal with print on demand compilation of issues published. The journal’s full text is available online at http://www.jmsjournal.net. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
