Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: A systematic review and meta-analysis

Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: A systematic review and meta-analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: A systematic review and meta-analysis Aditi Apte, Ashwini Parge, Radhika Nimkar, Anju Sinha This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4281216/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 07 Feb, 2025 Read the published version in BMC Nutrition → Version 1 posted 12 You are reading this latest preprint version Abstract Introduction This review aims to assess the effect of oral administration of probiotics and/or prebiotics in children and women of reproductive age (WRA) to improve intestinal iron absorption, hemoglobin, and ferritin levels. Methods Randomized controlled trials from published literature on probiotics and or prebiotics for prevention or treatment of anemia as a supplement or fortification in children or WRA till Jan 31, 2023, were included. Studies on probiotics and prebiotics in patients with anemia due to other causes were excluded. Screening and data extraction was done using Distiller SR and meta-analysis was performed using Revman 5.4.1. Results Total 1925 records were identified from Pubmed, Embase, and Cochrane, of which 29 were included in the systematic review (14 supplementation and 15 fortification studies; 15 studies in children and 14 studies in WRA). The major interventions included galacto-oligosaccharide, inulin, heat-killed H61, Lactobacillus plantarum 299v, Lactobacillus reuteri , Lactobacillus acidophilus . Meta-analysis of 9 studies (3 in WRA and 6 in children) showed that the use of prebiotics and/or probiotics was associated with little or no effect on hemoglobin as compared to control [Very low certainty of evidence]. Use of prebiotic and/or probiotic led to a significant increase in ferritin levels in WRA (mean increase 2.39 ng/ml, 95% CI 0.48-4.29, p=0.01, n=133) vs control (n=129) but not in children [Low certainty of evidence]. Administration of a prebiotic and/or probiotic along with oral iron was not associated with increased hemoglobin or ferritin vs administration of iron only (2 studies in WRA and children each) [Low to moderate certainty of evidence]. Use of prebiotics and/or probiotics was associated with 1.39% and 6.92% increase in fractional iron absorption in WRA when given alone or along with iron. However, iron absorption was not found to be increased in children [Low certainty of evidence]. Conclusion There is some evidence to show that the use of prebiotics or probiotics (especially Lp299v and GOS) can improve iron absorption in women and children and lead to improvement in ferritin levels in women. However, the current evidence does not conclusively show the benefit of these interventions in improving hemoglobin levels in women and children. Anemia iron bioavailability iron deficiency ferritin Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryTable1and21.docx Cite Share Download PDF Status: Published Journal Publication published 07 Feb, 2025 Read the published version in BMC Nutrition → Version 1 posted Editorial decision: Revision requested 29 Nov, 2024 Reviews received at journal 26 Nov, 2024 Reviews received at journal 24 Nov, 2024 Reviewers agreed at journal 16 Nov, 2024 Reviewers agreed at journal 16 Nov, 2024 Reviews received at journal 27 Oct, 2024 Reviewers agreed at journal 16 Oct, 2024 Reviewers invited by journal 03 Oct, 2024 Editor invited by journal 06 Jun, 2024 Submission checks completed at journal 19 Apr, 2024 Editor assigned by journal 19 Apr, 2024 First submitted to journal 17 Apr, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4281216","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":296080534,"identity":"d50ae18e-c75c-43fa-becf-fc8fceefa57d","order_by":0,"name":"Aditi 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Studies on probiotics and prebiotics in patients with anemia due to other causes were excluded. Screening and data extraction was done using Distiller SR and meta-analysis was performed using Revman 5.4.1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTotal 1925 records were identified from Pubmed, Embase, and Cochrane, of which 29 were included in the systematic review (14 supplementation and 15 fortification studies; 15 studies in children and 14 studies in WRA). The major interventions included galacto-oligosaccharide, inulin, heat-killed H61, \u003cem\u003eLactobacillus plantarum\u003c/em\u003e 299v, \u003cem\u003eLactobacillus reuteri\u003c/em\u003e, \u003cem\u003eLactobacillus acidophilus\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eMeta-analysis of 9 studies (3 in WRA and 6 in children) showed that the use of prebiotics and/or probiotics was associated with little or no effect on hemoglobin as compared to control [Very low certainty of evidence]. Use of prebiotic and/or probiotic led to a significant increase in ferritin levels in WRA (mean increase 2.39 ng/ml, 95% CI 0.48-4.29, p=0.01, n=133) vs control (n=129) but not in children [Low certainty of evidence]. Administration of a prebiotic and/or probiotic along with oral iron was not associated with increased hemoglobin or ferritin vs administration of iron only (2 studies in WRA and children each) [Low to moderate certainty of evidence]. Use of prebiotics and/or probiotics was associated with 1.39% and 6.92% increase in fractional iron absorption in WRA when given alone or along with iron. However, iron absorption was not found to be increased in children [Low certainty of evidence].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere is some evidence to show that the use of prebiotics or probiotics (especially Lp299v and GOS) can improve iron absorption in women and children and lead to improvement in ferritin levels in women. However, the current evidence does not conclusively show the benefit of these interventions in improving hemoglobin levels in women and children.\u003c/p\u003e","manuscriptTitle":"Effect of probiotic and prebiotics supplementation on hemoglobin levels and iron absorption among women of reproductive age and children: A systematic review and meta-analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-29 02:14:40","doi":"10.21203/rs.3.rs-4281216/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-29T05:26:13+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-26T14:56:45+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-25T01:54:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"202993560951981463429383168658902647020","date":"2024-11-16T13:41:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"53467536358688002172388486098647888424","date":"2024-11-16T10:35:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-27T17:19:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"63223625832259597998556322721756660723","date":"2024-10-16T09:18:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-10-03T05:29:33+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-06-06T13:26:58+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-04-19T08:04:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-04-19T08:04:23+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nutrition","date":"2024-04-17T10:20:58+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nutrition","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nutn","sideBox":"Learn more about [BMC Nutrition](http://bmcnutr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nutn/default.aspx","title":"BMC Nutrition","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8fee981e-dc79-4e74-99a5-f570cfb12824","owner":[],"postedDate":"May 29th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-02-10T16:09:32+00:00","versionOfRecord":{"articleIdentity":"rs-4281216","link":"https://doi.org/10.1186/s40795-025-01015-3","journal":{"identity":"bmc-nutrition","isVorOnly":false,"title":"BMC Nutrition"},"publishedOn":"2025-02-07 15:58:10","publishedOnDateReadable":"February 7th, 2025"},"versionCreatedAt":"2024-05-29 02:14:40","video":"","vorDoi":"10.1186/s40795-025-01015-3","vorDoiUrl":"https://doi.org/10.1186/s40795-025-01015-3","workflowStages":[]},"version":"v1","identity":"rs-4281216","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4281216","identity":"rs-4281216","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}