Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
The Effect of Probiotics Added to Maternal Nutrition on Infantile Colic: A Systematic Review and Meta-analysis
Maternal Beslenmeye Eklenen Probiyotiklerin İnfantil Kolik Üzerine Etkisi: Sistematik Bir İnceleme ve Meta-analiz
Aysu YILDIZ KARAAHMETa, Gülümser DOLGUNb, Metehan ÖZENc
aDepartment of Midwifery, Haliç University Faculty of Health Sciences, İstanbul, TURKEY
bDepartment of Midwifery, İstanbul University Faculty of Health Science İstanbul, TURKEY
cAcıbadem University Faculty of Medicine, Department of Child Health and Diseases, İstanbul, TURKEY
Turkiye Klinikleri J Pediatr. 2021;30(2):105-16
doi: 10.5336/pediatr.2020-78942
Article Language: EN
Full Text
ABSTRACT
 Objective: This study thoroughly evaluates the available evidence examining the effect of probiotics and derivatives added to maternal nutrition on infantile colic. Material and Methods: A comprehensive, systematic search of PubMed, Web of Science, the Cochrane Library, CINAHL and ULAKBİM databases was completed. In the systematic review, we examined the evidence about probiotics that could potentially be included. Contrary to what is usual, our review included maternal nutrition, but not infant feeding. Outcomes data including treatment success and crying times of infantile colic were collected to conduct an analysis. Meta-analysis of study outcomes was performed using Review Manager. The Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach was used to assess the quality of the body of evidence for each outcome of this meta-analysis. PROSPERO; registration number CRD42020155237. Results: In the review, 4 studies (1,110 participants) were included. The agreement between the 2 researchers was excellent, with Cohen kappa scores [95% confidence interval (CI)]=0.95 (I0.88-1) for article selection and 0.97 (I0.92-1) for bias scoring. The end of the intervention did not find a significant difference in treatment success between the 2 groups [risk ratio (RR) 1.14; 95% CI (0.4, 2.71)]. In a sensitivity analysis using the fixed effect model, we found a significant difference in favor of probiotics [RR 0.92; 95% CI (0.60, 1.42)]. Conclusion: Research suggests that the addition of some probiotics in the diet of mothers is reasonable for the treatment of infantile colic. However, more research is needed.

Keywords: Probiotic; prebiotic; infantile colic; maternal nutrition; meta-analysis
ÖZET
 Amaç: Bu çalışma, anne beslenmesine eklenen probiyotik ve türevlerinin, infantil kolik üzerindeki etkisini inceleyen mevcut kanıtları derinlemesine değerlendirmektedir. Gereç ve Yöntemler: PubMed, Web of Science, Cochrane Library, CINAHL ve ULAKBİM veri tabanlarının kapsamlı ve sistematik araştırması tamamlandı. İnfantil kolik tedavi başarısı ve ağlama sürelerini içeren sonuç verileri, analiz yapmak için toplandı. Sistematik incelemede, potansiyel olarak dâhil edilebilecek probiyotiklerle ilgili kanıtları inceledik. Alışılmışın aksine incelememiz, bebek beslemesini değil anne beslenmesini içeriyordu. Çalışma sonuçlarının metaanalizi, 'Review Manager' kullanılarak gerçekleştirildi. Tavsiye, Değerlendirme, Geliştirme ve Değerlendirme Çalışma Grubu Dereceleri (GRADE) yaklaşımı, bu metaanalizin her bir sonucunun kanıt kalitesini değerlendirmek için kullanıldı. PROSPERO; kayıt numarası CRD42020155237 idi. Bulgular: İncelemeye, 4 çalışma (1.110 katılımcı) dâhil edildi. Makale seçimi için Cohen kappa skorları [%95 güven aralığı (GA)]=0,95 (I0,88-1) ve ön yargı skorlaması için 0,97 (I0,92-1) ile 2 araştırmacı arasındaki uyum mükemmeldi. Müdahalenin sonunda 2 grup arasında tedavi başarısında anlamlı bir fark bulamadık [risk oranı (RO) 1,14; %95 GA (0,4; 2,71)]. Sabit etki modelini kullanan bir duyarlılık analizinde, probiyotikler lehine anlamlı bir fark bulduk [RO 0,92; %95 GA (0,60; 1,42)]. Sonuç: Araştırmalar, annelerin diyetine bazı probiyotiklerin eklenmesinin, infantil kolik tedavisi için makul olduğunu göstermektedir. Ancak daha fazla araştırmaya ihtiyaç vardır.

Anahtar Kelimeler: Probiyotik; prebiyotik; infantil kolik; maternal beslenme; meta-analiz
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