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Effect of probiotic supplementation during pregnancy and infancy in preventing atopic dermatitis in children: a Meta analysis
YIN Dao-Gen, HE Zhen, DUAN Xue-Yan, FAN Fei-Xiang, LIAO Xiao-Bing, WANG Qing-Chuan
Chinese Journal of Contemporary Pediatrics ›› 2019, Vol. 21 ›› Issue (1) : 82-88.
PDF(1693 KB)
PDF(1693 KB)
Effect of probiotic supplementation during pregnancy and infancy in preventing atopic dermatitis in children: a Meta analysis
Objective To systematically review the effect of probiotic supplementation during pregnancy and infancy in preventing atopic dermatitis in children. Methods RevMan5.3 was used to perform a Meta analysis of randomized controlled trials on the effect of probiotic supplementation during pregnancy and infancy in preventing atopic dermatitis in children published between January 2008 and May 2018 across the world. A subgroup analysis was conducted according to the type of probiotics for intervention, follow-up time, time of probiotic supplementation, and study areas. Results A total of 22 articles were selected, with 3 280 cases in the intervention group and 3 281 cases in the control group. The results of pooled effect size showed that probiotic supplementation during pregnancy and/or infancy significantly reduced the incidence rate of atopic dermatitis (RR=0.81, 95% CI:0.70-0.93, P < 0.05). According to the subgroup analysis, the intervention with Lactobacillus and Bifidobacterium had a significant effect (RR=0.68, 95% CI:0.52-0.90, P < 0.05); probiotic supplementation during both pregnancy and infancy also had a significant effect (RR=0.77, 95% CI:0.66-0.90, P < 0.05); probiotic supplementation during pregnancy and/or infancy had a better effect in preventing atopic dermatitis in children aged ≤ 2 years than in those aged > 2 years (RR=0.74, 95% CI:0.61-0.90, P < 0.05); probiotic supplementation had a significant effect in Australia (RR=0.83, 95% CI:0.73-0.96, P < 0.05) and Europe/the United States (RR=0.74, 95% CI:0.61-0.91, P < 0.05). Heterogeneity was mainly due to follow-up time (I2=62.7%) and time of probiotic supplementation (I2=53.5%). Conclusions Probiotic supplementation during pregnancy and infancy helps to prevent atopic dermatitis in children, and mixed Lactobacillus-Bifidobacterium intervention has a better effect.
Atopic dermatitis / Probiotics / Randomized controlled trial / Meta analysis / Child
[1] Koet LBM, Brand PLP. Increase in atopic sensitization rate among Dutch children with symptoms of allergic disease between 1994 and 2014[J]. Pediatr Allergy Immunol, 2018, 29(1):78-83.
[2] 王雪梅, 王玲. 2005-2014年中国儿童哮喘与过敏体质、家族史、被动吸烟病例对照研究的Meta分析[J]. 中国妇幼保健, 2017, 32(6):1351-1354.
[3] Ou CY, Kuo HC, Wang L, et al. Prenatal and postnatal probiotics reduces maternal but not childhood allergic diseases:a randomized, double-blind, placebo-controlled trial[J]. Clin Exp Allergy, 2012, 42(9):1386-1396.
[4] West CE, Jenmalm MC, Prescott SL. The gut microbiota and its role in the development of allergic disease:a wider perspective[J]. Clin Exp Allergy, 2015, 45(1):43-53.
[5] 曾燕, 刘小芸, 邓全敏. 饮食干预对高过敏风险婴儿过敏预防的疗效观察[J]. 中国儿童保健杂志, 2015, 23(7):756-759.
[6] Zhang GQ, Liu CY, Zhang Q, et al. Probiotics for prevention of atopy and food hypersensitivity in early childhood:a PRISMAcompliant systematic review and meta-analysis of randomized controlled trials[J]. Medicine (Baltimore), 2016, 95(8):e2562.
[7] Zuccotti G, Meneghin F, Aceti A, et al. Probiotics for prevention of atopic diseases in infants:systematic review and metaanalysis[J]. Allergy, 2015, 70(11):1356-1371.
[8] 曾宪涛, 包翠萍, 曹世义, 等. Meta分析系列之三:随机对照试验的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(3):183-185.
[9] Abrahamsson TR, Jakobsson T, Bjorksten B, et al. No effect of probiotics on respiratory allergies:a seven-year follow-up of a randomized controlled trial in infancy[J]. Pediatr Allergy Immunol, 2013, 24(6):556-561.
[10] Böttcher MF, Abrahamsson TR, Fredriksson M, et al. Low breast milk TGF-beta2 is induced by Lactobacillus reuteri supplementation and associates with reduced risk of sensitization during infancy[J]. Pediatr Allergy Immunol, 2008, 19(6):497-504.
[11] Boyle RJ, Ismail IH, Kivivuori S, et al. Lactobacillus GG treatment during pregnancy for the prevention of eczema:a randomized controlled trial[J]. Allergy, 2011, 66(4):509-516.
[12] Huurre A, Laitinen K, Rautava S, et al. Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization:a double blind placebo-controlled study[J]. Clin Exp Allergy, 2008, 38(8):1342-1348.
[13] Kim JY, Kwon JH, Ahn SH, et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema:a doubleblind, randomized, placebo-controlled trial[J]. Pediatr Allergy Immunol, 2010, 21:e386-e393.
[14] Kopp MV, Hennemuth I, Heinzmann A, et al. Randomized, double-blind, placebo-controlled trial of probiotics for primary prevention:no clinical effects of Lactobacillus GG supplementation[J]. Pediatrics, 2008, 121(4):e850-e856.
[15] Niers L, Martin R, Rijkers G, et al. The effects of selected probiotic strains on the development of eczema (the PandA study)[J]. Allergy, 2009, 64(9):1349-1358.
[16] Prescott SL, Wiltschut J, Taylor A, et al. Early markers of allergic disease in a primary prevention study using probiotics:2.5-year follow-up phase[J]. Allergy, 2008, 63(11):1481-1490.
[17] Rautava S, Kainonen E, Salminen S, et al. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant[J]. J Allergy Clin Immunol, 2012, 130(6):1355-1360.
[18] Wickens K, Black P, Stanley TV, et al. A protective effect of Lactobacillus rhamnosus HN001 against eczema in the first 2 years of life persists to age 4 years[J]. Clin Exp Allergy, 2012, 42(7):1071-1079.
[19] Wickens K, Black PN, Stanley TV, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy:a doubleblind, randomized, placebo-controlled trial[J]. J Allergy Clin Immunol, 2008, 122(4):788-794.
[20] Wickens K, Stanley TV, Mitchell EA, et al. Early supplementation with Lactobacillus rhamnosus HN001 reduces eczema prevalence to 6 years:does it also reduce atopic sensitization?[J]. Clin Exp Allergy, 2013, 43(9):1048-1057.
[21] 吴福玲, 冯学斌, 刘秀香, 等. 双歧杆菌对母乳成分的影响及其与婴儿过敏性疾病的关系[J]. 临床儿科杂志, 2010, 28(3):260-263.
[22] Allen SJ, Jordan S, Storey M, et al. Probiotics in the prevention of eczema:a randomised controlled trial[J]. Arch Dis Child, 2014, 99(11):1014-1019.
[23] Cabana MD, Mckean M, Caughey AB, et al. Early probiotic supplementation for eczema and asthma prevention:a randomized controlled trial[J]. Pediatircs, 2017, 140(3):e20163000.
[24] Dotterud CK, Storrø O, Johnsen R, et al. Probiotics in pregnant women to prevent allergic disease:a randomized, double-blind trial[J]. Br J Dermatol, 2010, 163(3):616-623.
[25] Jensen MP, Meldrum S, Taylor AL, et al. Early probiotic supplementation for allergy prevention:long-term outcomes[J]. J Allergy Clin Immunol, 2012, 130:1209-1211.
[26] Soh SE, Aw M, Gerez I, et al. Probiotic supplementation in the first 6 months of life in at risk Asian infants-effects on eczema and atopic sensitization at the age of 1 year[J]. Clin Exp Allergy, 2009, 39(4):571-578.
[27] Kuitunen M, Kukkonen K, Juntunen-Backman K, et al. Probiotics prevent IgE-associated allergy until age 5 years in cesarean-delivered children but not in the total cohort[J]. J Allergy Clin Immunol, 2009, 123(2):335-341.
[28] West CE, Hammarström ML, Hernell O, et al. Probiotics in primary prevention of allergic disease-follow-up at 8-9 years of age[J]. Allergy, 2013, 68(8):1015-1020.
[29] West CE, Hammarström ML, Hernell O. Probiotics during weaning reduce the incidence of eczema[J]. Pediatr Allergy Immunol, 2009, 20(5):430-437.
[30] 罗宇阳, 吴薇岚, 吴葆宁, 等. 南宁市0~24个月婴幼儿过敏性疾病的临床特征及相关影响因素分析[J]. 中国妇幼保健, 2018, 33(1):132-135.
[31] 夏利平, 姜毅. 益生菌在儿童变态反应性疾病中的防治作用[J]. 中国当代儿科杂志, 2016, 18(2):189-194.
[32] 单延春, 冯雪英, 衣明纪, 等. 食物过敏儿童的生长状况与营养管理[J]. 中国儿童保健杂志, 2016, 24(10):1055-1058.
[33] 陈小丽, 吴佳音. 闽南地区3196例儿童过敏原检测结果分析[J]. 中国妇幼保健, 2016, 31(23):5053-5055.
[34] 周佳, 许正浩, 赵华伟. 益生菌预防婴幼儿湿疹复发作用的Meta分析[J]. 海峡药学, 2016, 28(6):152-154.
[35] Floch MH, Walker WA, Sanders ME, et al. Recommendations for probiotic use -2015 update:proceedings and consensus opinion[J]. J Clin Gastroenterol, 2015, 49(Suppl 1):S69-S73.
[36] Fiocchi A, Pawankar R, Cuello-Garcia C, et al. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P):Probiotics[J]. World Allergy Organ J, 2015, 8(1):4.
