The effectiveness of probiotic supplementation as an adjunct to phototherapy in the management of neonatal hyperbilirubinemia: a systematic review and meta-analysis

AIM: This meta-analysis aims to determine the effect of probiotic supplementation, administered together with phototherapy, on hyperbilirubinemia levels in the treatment of neonatal jaundice. METHOD: This study was carried out between July and October 2024 utilizing the PubMed, Web of Science, EBSCOhost, National Thesis Center of the Council of Higher Education (YÖK), and Google Scholar databases. The data collection and analysis processes were conducted by three independent researchers. Fourteen eligible studies were included. Study quality was assessed with the Joanna Briggs Institute (JBI) tool. Data were analyzed using Comprehensive Meta-Analysis (CMA) Version 2. Findings were synthesized through meta-analysis and narrative methods. RESULTS: Given the results of the meta-analysis based on the findings reported by the studies, probiotics administered in conjunction with phototherapy had a significant effect on hyperbilirubinemia levels among newborns (SMD: -0.364, 95% CI: -0.700 to -0.028; Z = -2.121, p = 0.034). Meta-analysis findings showed significant heterogeneity among studies (I²=88.7; p < 0.001). This high level of heterogeneity substantially reduces confidence in the pooled estimate and suggests that the effect size may vary across different clinical settings. CONCLUSıON: This meta-analysis suggests probiotics may be a complementary treatment for neonatal hyperbilirubinemia. However, these findings should be interpreted with caution due to the high heterogeneity and variability among included studies. Due to differences in probiotic strains, dosage, and methodology among the studies, the generalizability of the results is limited. This research was not funded by any institution or organization, and there are no conflicts of interest among the authors.