{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:31:44Z","timestamp":1787927504628,"version":"build-2784847793"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Gut microbiota play an important role in bilirubin metabolism and may influence the course of neonatal physiological jaundice. This systematic review and meta-analysis aimed to evaluate the strain-specific efficacy of probiotics in the prevention and adjunctive treatment of neonatal physiological jaundice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A comprehensive search of PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library, World Health Organization databases, and Persian databases (Scientific information database [SID] and Magiran) for studies published up to 2024 was conducted. Randomized controlled trials (RCTs) evaluating probiotics in term and late-preterm neonates (\u226535 weeks) with physiological jaundice were included. Data extraction, quality assessment, and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using a random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Nineteen RCTs (13 therapeutic and 6 prophylactic) were included. Prophylactic probiotic administration was associated with a reduced need for phototherapy (odds ratio [OR] =0.60; 95% confidence interval [CI]: 0.37\u20130.96). As an adjunct to phototherapy, probiotics were associated with lower bilirubin levels (mean difference [MD] = \u22121.61; 95% CI: \u22123.10\u2013\u22120.11), shorter phototherapy duration (~5 h), and reduced hospitalization (0.3 days). Reduction in bilirubin was more evident during the 2\n                      <jats:sup>nd<\/jats:sup>\n                      and 3\n                      <jats:sup>rd<\/jats:sup>\n                      days of treatment. Strain-specific differences were observed;\n                      <jats:italic toggle=\"yes\">Clostridium butyricum<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Lactobacillus reuteri<\/jats:italic>\n                      demonstrated larger pooled effect sizes for bilirubin reduction, whereas\n                      <jats:italic toggle=\"yes\">Saccharomyces boulardii<\/jats:italic>\n                      showed greater protective effect against phototherapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Probiotics may serve as beneficial adjuncts in the prevention and management of neonatal physiological jaundice, with potential strain-dependent differences. Given heterogeneity and limited data for some strains, findings should be interpreted cautiously. Further well-designed, adequately powered RCTs are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jrms.jrms_746_25","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:07:48Z","timestamp":1787926068000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The best type of probiotic for the prevention and treatment of neonatal physiological jaundice: A systematic review and meta-analysis"],"prefix":"10.4103","volume":"31","author":[{"given":"Behzad","family":"Barekatain","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Asefi","sequence":"additional","affiliation":[{"name":"School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roya","family":"Kelishadi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Yazdi","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, United Kingdom"},{"name":"Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motahar","family":"Heidari-Beni","sequence":"additional","affiliation":[{"name":"Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5]]},"reference":[{"key":"R1-20260828","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1001\/archpedi.1961.04020020089014","article-title":"Neonatal jaundice. 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