title: Probiotics for prevention of atopic diseases in infants: systematic review and meta-analysis.
abstract: Growing evidence underlines the pivotal role of infant gut colonization in the development of the immune system. The possibility to modify gut colonization through probiotic supplementation in childhood might prevent atopic diseases. The aim of the present systematic review and meta-analysis was to evaluate the effect of probiotic supplementation during pregnancy and early infancy in preventing atopic diseases. PubMed, Embase and Cochrane Library were searched for randomized controlled trials evaluating the use of probiotics during pregnancy or early infancy for prevention of allergic diseases. Fixed-effect models were used, and random-effects models where significant heterogeneity was present. Results were expressed as risk ratio (RR) with 95% confidence interval (CI). Seventeen studies, reporting data from 4755 children (2381 in the probiotic group and 2374 in the control group), were included in the meta-analysis. Infants treated with probiotics had a significantly lower RR for eczema compared to controls (RR 0.78 [95% CI: 0.69-0.89], P = 0.0003), especially those supplemented with a mixture of probiotics (RR 0.54 [95% CI: 0.43-0.68], P < 0.00001). No significant difference in terms of prevention of asthma (RR 0.99 [95% CI: 0.77-1.27], P = 0.95), wheezing (RR 1.02 [95% CI: 0.89-1.17], P = 0.76) or rhinoconjunctivitis (RR 0.91 [95% CI: 0.67-1.23], P = 0.53) was documented. The results of the present meta-analysis show that probiotic supplementation prevents infantile eczema, thus suggesting a new potential indication for probiotic use in pregnancy and infancy.
authors.affiliation: Department of Pediatrics, Children Hospital V. Buzzi, University of Milan, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Zuccotti
authors.affiliation: Department of Pediatrics, L. Sacco Hospital, University of Milan, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Meneghin
authors.affiliation: Neonatology and Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Aceti
authors.affiliation: Neonatal Unit, Catholic University, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Barone
authors.affiliation: Institute of Microbiology, UCSC, Piacenza, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Callegari
authors.affiliation: Department of Pediatrics, Aldo Moro University, Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Mauro
authors.affiliation: Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
authors.forename: M P
authors.initials: MP
authors.lastname: Fantini
authors.affiliation: Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Gori
authors.affiliation: Department of Pediatrics, Aldo Moro University, Bari, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Indrio
authors.affiliation: Neonatal Unit, Catholic University, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Maggio
authors.affiliation: Institute of Microbiology, UCSC, Piacenza, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Morelli
authors.affiliation: Neonatology and Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Corvaglia
mesh_terms: D000367:Age Factors; D001249:Asthma / Q000517:prevention & control; D003233:Conjunctivitis, Allergic / Q000517:prevention & control; D004485:Eczema / Q000517:prevention & control; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000517:prevention & control*; D007223:Infant; D007231:Infant, Newborn; D016017:Odds Ratio; D019936:Probiotics / Q000627:therapeutic use*; D012135:Respiratory Sounds; D065631:Rhinitis, Allergic / Q000517:prevention & control
keywords: atopic diseases; infant; meta-analysis; probiotic