EFFICACY OF PROBIOTIC PROPHYLAXIS IN THE PREVENTION OF NECROTIZING ENTEROCOLITIS IN VERY LOW BIRTH WEIGHT PREMATURE INFANTS: A LITERATURE REVIEW

Abstract

This article aimed to review the scientific evidence on the efficacy of probiotic prophylaxis in the prevention of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) preterm infants, defined as those weighing less than 1,500 g. A narrative literature review was conducted in PubMed/MEDLINE, SciELO, LILACS, and the Cochrane Library, covering publications from 2010 to 2025. Randomized controlled trials, systematic reviews, and meta-analyses evaluating probiotic administration as prophylaxis for NEC in VLBW preterm neonates were included. Results showed that probiotic supplementation significantly reduces the incidence of NEC ≥ Bell stage II, with a pooled relative risk of 0.54 (95% CI: 0.45–0.65) in Cochrane analyses and an OR of 0.35 (95% CI: 0.20–0.59) for combined Lactobacillus spp. and Bifidobacterium spp. preparations in a network meta-analysis published in Gastroenterology. Significant reductions in overall mortality and late-onset sepsis were also identified. Multistrain mixtures proved superior to single-strain formulations. In conclusion, probiotic prophylaxis represents an effective, safe, and low-cost intervention for NEC prevention in VLBW premature infants and should be systematically incorporated into Neonatal Intensive Care Unit (NICU) protocols.