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Effect of Supplementation with Probiotics, Prebiotics, Synbiotics, Omega 3, and Vitamin D for the Prevention of Allergy in Infants: A Systematic Review and Network Meta Analysis
Other Title
Effect of Supplementation with Probiotics, Prebiotics, Synbiotics, Omega 3, and Vitamin D for the Prevention of Allergy in Infants: A Systematic Review and Network Meta Analysis
Type
thesis
Date Issued
2025-07-18
Author(s)
Ali Maria Jama
Advisor
譚家偉
Subjects
系所名稱：國際醫學研究碩士學位學程
Publisher
國際醫學研究碩士學位學程
Description
學位別：碩士
口試委員：陳可欣; 羅爾維; 譚家偉
關鍵字：Allergy prevention、infancy、probiotics、prebiotics、omega-3 fatty acids、vitamin D、maternal nutrition、network meta-analysis、eczema、asthma、food allergy、IgE sensitization、synbiotics
口試委員：陳可欣; 羅爾維; 譚家偉
關鍵字：Allergy prevention、infancy、probiotics、prebiotics、omega-3 fatty acids、vitamin D、maternal nutrition、network meta-analysis、eczema、asthma、food allergy、IgE sensitization、synbiotics
Abstract
Abstract
Background: The global burden of childhood allergic diseases, including eczema, food allergy, IgE sensitization, and wheezing or asthma, is rising, with onset often occurring during infancy. Early-life nutritional interventions may play a preventive role by modulating immune development during critical periods.
Objective: To evaluate and compare the effectiveness of maternal and/or infant supplementation with probiotics, prebiotics, synbiotics, omega-3 fatty acids, and vitamin D in preventing major allergic outcomes in infancy, including eczema, wheezing/asthma, food allergy, and IgE sensitization.
Methods: We conducted a systematic review and network meta-analysis of 41 randomized controlled trials. Interventions were administered during pregnancy, lactation, and/or infancy. Outcomes were stratified by exposure group (maternal, infant, or both). Risk of bias was assessed using the Cochrane RoB 2.0 tool, and the certainty of evidence was evaluated using the CINeMA framework.
Results: Maternal omega-3 supplementation consistently reduced the risk of all four allergic outcomes: eczema (relative risk [RR] = 0.66), wheezing/asthma (RR = 0.63), food allergy (RR = 0.51), and IgE sensitization (RR = 0.48). Maternal probiotic use also showed potential benefits across multiple outcomes. In contrast, infant-only supplementation was less effective, suggesting greater benefit from prenatal exposure. Synbiotics showed possible effectiveness in infancy, but evidence was limited to one trial. Results for prebiotics and vitamin D were inconclusive. Certainty of evidence was generally low, with concerns about imprecision, heterogeneity, and indirectness. No major publication bias was identified.
Conclusion: Maternal omega-3 supplementation appears to be the most promising nutritional intervention for preventing major allergic outcomes in infancy. Probiotic use during pregnancy may also provide benefits. However, due to low certainty and limited long-term follow-up, current evidence does not support routine use. More high-quality trials with harmonized methods and extended follow-up are required to clarify their preventive potential.
Keywords: Allergy prevention, infancy, probiotics, prebiotics, synbiotics, omega-3 fatty acids, vitamin D, maternal nutrition, network meta-analysis, eczema, asthma, food allergy, IgE sensitization
Background: The global burden of childhood allergic diseases, including eczema, food allergy, IgE sensitization, and wheezing or asthma, is rising, with onset often occurring during infancy. Early-life nutritional interventions may play a preventive role by modulating immune development during critical periods.
Objective: To evaluate and compare the effectiveness of maternal and/or infant supplementation with probiotics, prebiotics, synbiotics, omega-3 fatty acids, and vitamin D in preventing major allergic outcomes in infancy, including eczema, wheezing/asthma, food allergy, and IgE sensitization.
Methods: We conducted a systematic review and network meta-analysis of 41 randomized controlled trials. Interventions were administered during pregnancy, lactation, and/or infancy. Outcomes were stratified by exposure group (maternal, infant, or both). Risk of bias was assessed using the Cochrane RoB 2.0 tool, and the certainty of evidence was evaluated using the CINeMA framework.
Results: Maternal omega-3 supplementation consistently reduced the risk of all four allergic outcomes: eczema (relative risk [RR] = 0.66), wheezing/asthma (RR = 0.63), food allergy (RR = 0.51), and IgE sensitization (RR = 0.48). Maternal probiotic use also showed potential benefits across multiple outcomes. In contrast, infant-only supplementation was less effective, suggesting greater benefit from prenatal exposure. Synbiotics showed possible effectiveness in infancy, but evidence was limited to one trial. Results for prebiotics and vitamin D were inconclusive. Certainty of evidence was generally low, with concerns about imprecision, heterogeneity, and indirectness. No major publication bias was identified.
Conclusion: Maternal omega-3 supplementation appears to be the most promising nutritional intervention for preventing major allergic outcomes in infancy. Probiotic use during pregnancy may also provide benefits. However, due to low certainty and limited long-term follow-up, current evidence does not support routine use. More high-quality trials with harmonized methods and extended follow-up are required to clarify their preventive potential.
Keywords: Allergy prevention, infancy, probiotics, prebiotics, synbiotics, omega-3 fatty acids, vitamin D, maternal nutrition, network meta-analysis, eczema, asthma, food allergy, IgE sensitization