Probiotics unrelated to asthma and wheeze prevention in children

Image: PD 

1. Investigators found that children exposed to probiotics during pregnancy or the first year of life are equally at risk for asthma, wheeze, and lower respiratory tract infections.

Evidence Rating Level: 2 (Good) 

Study Rundown: This meta-analysis aggregated results from 20 studies, across various countries, to evaluate the impact of probiotic use on asthma and wheeze in infants. Researchers found little difference in rates of asthma among a population (n=3257) of infants exposed to probiotics during pregnancy or within the first year of life (11.2%) compared to a control group (10.2%). Similar results were identified when researchers looked at the diagnosis of childhood wheeze: 35.0% among probiotic users compared to 31.1% in the control group. These results led the researchers to conclude that probiotics have no comparative benefit for infants in preventing asthma or wheeze. Researchers acknowledge that all studies reviewed in this meta-analysis have varying lengths of follow-up and different organisms used at different doses. However, the effects of these variables are not fully evaluated in the results. Future research connecting probiotic use to specific immune system development will help direct the value of preventive treatments in infants for allergic diseases including respiratory illness.

Click to read the study in British Medical Journal

Relevant Reading: Perinatal programming of asthma: the role of gut microbiota

In-Depth [meta-analysis]: Investigators found no statistical differences in rates of asthma or wheeze based on geography, organism, dosage, caesarean section, or breast feeding during early childhood (n=3257). The probiotic doses ranged from 10⁸ to 10¹¹ colony forming units and most commonly included L rhamnosus, L acidophilus, and B lactis. For the primary outcome of asthma, researchers found there to be no significant difference in diagnosis between probiotic use (11.2%) and placebo (10.2%) (risk ratio 0.99, 95% CI: 0.81 to 1.21, I²=0%). Furthermore, in evaluating wheeze researchers found similar results (35.0% probiotic use v 31.1% placebo) (risk ratio 0.97. 95% CI: 0.87 to 1.09, I²=0%).

By Jordan Anderson and Andrew Bishara

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