title: 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).
authors.affiliation: Mario Negri Institute for Pharmacological Research, Milan, Italy. claudio.pelucchi@marionegri.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Pelucchi
authors.forename: Liliane
authors.initials: L
authors.lastname: Chatenoud
authors.forename: Federica
authors.initials: F
authors.lastname: Turati
authors.forename: Carlotta
authors.initials: C
authors.lastname: Galeone
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Moja
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bach
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D003876:Dermatitis, Atopic / Q000276:immunology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D061148:Hygiene Hypothesis; D007073:Immunoglobulin E / Q000276:immunology; D007223:Infant; D007231:Infant, Newborn; D015233:Models, Statistical; D011247:Pregnancy; D011295:Prenatal Care; D019936:Probiotics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007073:Immunoglobulin E