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Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis.

Abstract

BACKGROUND

The study of probiotics to prevent allergic conditions has yielded conflicting results in children. We undertook a meta-analysis of randomized controlled trials to investigate whether probiotic use during pregnancy and early life decreases the incidence of atopic dermatitis and immunoglobulin E (IgE)-associated atopic dermatitis in infants and young children.

METHODS

We performed a systematic literature search in Medline, Embase, and Cochrane Library, updated to October 2011. The intervention was diet supplementation with probiotics versus placebo. Primary outcomes were incidence of atopic dermatitis and IgE-associated atopic dermatitis. We calculated summary relative risks (RRs) and corresponding 95% confidence intervals (CIs), using both fixed- and random-effects models. We computed summary estimates across several strata, including study period, type of patient, dose, and duration of intervention, and we assessed the risk of bias within and across trials.

RESULTS

We identified 18 publications based on 14 studies. Meta-analysis demonstrated that probiotic use decreased the incidence of atopic dermatitis (RR = 0.79 [95% CI = 0.71-0.88]). Studies were fairly homogeneous (I = 24.0%). The corresponding RR of IgE-associated atopic dermatitis was 0.80 (95% CI = 0.66-0.96). No appreciable difference emerged across strata, nor was there evidence of publication bias.

CONCLUSIONS

This meta-analysis provided evidence in support of a moderate role of probiotics in the prevention of atopic dermatitis and IgE-associated atopic dermatitis in infants. The favorable effect was similar regardless of the time of probiotic use (pregnancy or early life) or the subject(s) receiving probiotics (mother, child, or both).

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  • Authors+Show Affiliations

    ,

    Mario Negri Institute for Pharmacological Research, Milan, Italy. claudio.pelucchi@marionegri.it

    , , , , ,

    Source

    Epidemiology (Cambridge, Mass.) 23:3 2012 May pg 402-14

    MeSH

    Dermatitis, Atopic
    Female
    Humans
    Hygiene Hypothesis
    Immunoglobulin E
    Infant
    Infant, Newborn
    Models, Statistical
    Pregnancy
    Prenatal Care
    Probiotics
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    22441545

    Citation

    Pelucchi, Claudio, et al. "Probiotics Supplementation During Pregnancy or Infancy for the Prevention of Atopic Dermatitis: a Meta-analysis." Epidemiology (Cambridge, Mass.), vol. 23, no. 3, 2012, pp. 402-14.
    Pelucchi C, Chatenoud L, Turati F, et al. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology. 2012;23(3):402-14.
    Pelucchi, C., Chatenoud, L., Turati, F., Galeone, C., Moja, L., Bach, J. F., & La Vecchia, C. (2012). Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology (Cambridge, Mass.), 23(3), pp. 402-14. doi:10.1097/EDE.0b013e31824d5da2.
    Pelucchi C, et al. Probiotics Supplementation During Pregnancy or Infancy for the Prevention of Atopic Dermatitis: a Meta-analysis. Epidemiology. 2012;23(3):402-14. PubMed PMID: 22441545.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. AU - Pelucchi,Claudio, AU - Chatenoud,Liliane, AU - Turati,Federica, AU - Galeone,Carlotta, AU - Moja,Lorenzo, AU - Bach,Jean-François, AU - La Vecchia,Carlo, PY - 2012/3/24/entrez PY - 2012/3/24/pubmed PY - 2012/8/2/medline SP - 402 EP - 14 JF - Epidemiology (Cambridge, Mass.) JO - Epidemiology VL - 23 IS - 3 N2 - BACKGROUND: The study of probiotics to prevent allergic conditions has yielded conflicting results in children. We undertook a meta-analysis of randomized controlled trials to investigate whether probiotic use during pregnancy and early life decreases the incidence of atopic dermatitis and immunoglobulin E (IgE)-associated atopic dermatitis in infants and young children. METHODS: We performed a systematic literature search in Medline, Embase, and Cochrane Library, updated to October 2011. The intervention was diet supplementation with probiotics versus placebo. Primary outcomes were incidence of atopic dermatitis and IgE-associated atopic dermatitis. We calculated summary relative risks (RRs) and corresponding 95% confidence intervals (CIs), using both fixed- and random-effects models. We computed summary estimates across several strata, including study period, type of patient, dose, and duration of intervention, and we assessed the risk of bias within and across trials. RESULTS: We identified 18 publications based on 14 studies. Meta-analysis demonstrated that probiotic use decreased the incidence of atopic dermatitis (RR = 0.79 [95% CI = 0.71-0.88]). Studies were fairly homogeneous (I = 24.0%). The corresponding RR of IgE-associated atopic dermatitis was 0.80 (95% CI = 0.66-0.96). No appreciable difference emerged across strata, nor was there evidence of publication bias. CONCLUSIONS: This meta-analysis provided evidence in support of a moderate role of probiotics in the prevention of atopic dermatitis and IgE-associated atopic dermatitis in infants. The favorable effect was similar regardless of the time of probiotic use (pregnancy or early life) or the subject(s) receiving probiotics (mother, child, or both). SN - 1531-5487 UR - https://www.unboundmedicine.com/medline/citation/22441545/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=22441545 DB - PRIME DP - Unbound Medicine ER -