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    <IdentifierDoi>10.3205/26kgg666</IdentifierDoi>
    <IdentifierUrn>urn:nbn:de:0183-26kgg6661</IdentifierUrn>
    <ArticleType>Meeting Abstract</ArticleType>
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      <Title language="en">Pro- and synbiotic supplementation during pregnancy and infancy to prevent atopic eczema: a systematic review and individual participant data meta-analysis</Title>
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          <Affiliation>Otto-von-Guericke Universit&#228;t Magdeburg, Institut f&#252;r Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Deutschland</Affiliation>
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          <Affiliation>Otto-von-Guericke Universit&#228;t Magdeburg, Institut f&#252;r Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Deutschland</Affiliation>
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          <Affiliation>Otto-von-Guericke Universit&#228;t Magdeburg, Institut f&#252;r Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Deutschland</Affiliation>
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          <Affiliation>Otto-von-Guericke Universit&#228;t Magdeburg, Institut f&#252;r Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Deutschland</Affiliation>
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          <Affiliation>Otto-von-Guericke Universit&#228;t Magdeburg, Institut f&#252;r Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Deutschland</Affiliation>
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          <Affiliation>Otto-von-Guericke Universit&#228;t Magdeburg, Institut f&#252;r Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Deutschland</Affiliation>
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          <Affiliation>Otto-von-Guericke Universit&#228;t Magdeburg, Institut f&#252;r Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Deutschland</Affiliation>
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          <Affiliation>Imperial College London, School of Public Health, London, Gro&#223;britannien</Affiliation>
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          <Lastname>Apfelbacher</Lastname>
          <LastnameHeading>Apfelbacher</LastnameHeading>
          <Firstname>Christian</Firstname>
          <Initials>C</Initials>
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          <Affiliation>Otto-von-Guericke Universit&#228;t Magdeburg, Institut f&#252;r Sozialmedizin und Gesundheitssystemforschung, Magdeburg, Deutschland</Affiliation>
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          <Corporatename>German Medical Science GMS Publishing House</Corporatename>
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        <Address>D&#252;sseldorf</Address>
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    <SubjectGroup>
      <SubjectheadingDDB>610</SubjectheadingDDB>
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    <DatePublishedList>
      <DatePublished>20251030</DatePublished>
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    <Language>engl</Language>
    <License license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
      <AltText language="en">This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.</AltText>
      <AltText language="de">Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung).</AltText>
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      <Meeting>
        <MeetingId>M0662</MeetingId>
        <MeetingSequence>666</MeetingSequence>
        <MeetingCorporation>Deutsche Gesellschaft f&#252;r Allgemeinmedizin und Familienmedizin</MeetingCorporation>
        <MeetingCorporation>Deutsche Gesellschaft f&#252;r Sozialmedizin und Pr&#228;vention</MeetingCorporation>
        <MeetingCorporation>Netzwerk Evidenzbasierte Medizin e.V.</MeetingCorporation>
        <MeetingCorporation>Deutsche Gesellschaft f&#252;r Medizinische Soziologie</MeetingCorporation>
        <MeetingName>60. Kongress f&#252;r Allgemeinmedizin und Familienmedizin</MeetingName>
        <MeetingTitle>Gesundheit gestalten</MeetingTitle>
        <MeetingSession>Allergiepr&#228;vention zwischen Evidenz und Unsicherheit: Aktuelle Ergebnisse und methodische Herausforderungen in Evidenz und Leitlinien</MeetingSession>
        <MeetingCity>G&#246;ttingen</MeetingCity>
        <MeetingDate>
          <DateFrom>20260930</DateFrom>
          <DateTo>20261002</DateTo>
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    <ArticleNo>SYM-25-05</ArticleNo>
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      <MainHeadline>Text</MainHeadline><Pgraph><Mark1>Content:</Mark1> Atopic eczema (AE) is a chronic inflammatory skin disease particularly common in early childhood. Previous aggregate data meta-analyses have suggested that prenatal or infancy exposure to pro- and synbiotics may prevent atopic eczema, but evidence is inconsistent and heterogeneous.</Pgraph><Pgraph>To assess the effectiveness and quality of pro- and symbiotic supplementation during pregnancy or infancy in preventing AE in infants using individual participant data (IPD) meta-analysis.</Pgraph><Pgraph>PubMed, EMBASE and Cochrane CENTRAL were searched up to 10&#47;2025 without restrictions on language or publication year. Randomized controlled trials (RCTs) evaluating probiotics or synbiotics for the prevention of AE in pregnant and lactating people, and infants up to 12 months were eligible. Two independent reviewers screened titles and abstracts against predefined criteria and will assess the eligible full texts. The primary outcome is AE, assessed using a predefined outcome hierarchy (investigator assessment, physician diagnosis, and patient- or parent-reported eczema) when multiple measures were reported. Trial investigators will be contacted for de-identified IPD. If IPD cannot be obtained, aggregate data will be extracted from publications. A two-stage IPD meta-analysis is planned. Continuous outcomes will be summarized using mean differences or standardized mean differences, and dichotomous outcomes using risk ratios, with 95&#37; confidence intervals. We will use random-effects models in stage two to estimate the pooled treatment effect across studies. Heterogeneity will be assessed using &#964;&#178; and I&#178; statistics, and if at least ten studies are available, publication bias will be explored using funnel plots and Peter&#8217;s test.</Pgraph><Pgraph>The search identified 48,727 records. After de-duplication 22,770 records were screened at the title and abstract level. Of these, 185 studies met the eligibility criteria for full-text assessment. Full-text screening is ongoing. Initial outreach to trialists has begun to assess interest in data sharing and participation in the project. Formal IPD requests will be sent following completion of full-text screening.</Pgraph><Pgraph>This IPD meta-analysis will offer the possibility to look more closely at the participant-level data allowing consistent outcome definition and flexible participant level analyses.</Pgraph><Pgraph>The results are expected to provide more robust evidence on the potential of pro- and synbiotic intervention in the prevention of AE.</Pgraph><Pgraph><Mark1>Competing interests:</Mark1> Prof. Dr. Christian Apfelbacher ist PI und Sprecher der Forschungsgruppe HELICAP und zugleich im Kongresspr&#228;sidium der DGSMP.</Pgraph><Pgraph>Im Rahmen von HELICAP ist dieser Abstract&#47;dieses Symposium entstanden.</Pgraph><Pgraph>Die eingereichten Abstracts wurden unabh&#228;ngig erstellt. Es bestand kein Einfluss auf Auswahl- oder Begutachtungsprozesse; entsprechende Ma&#223;nahmen zur Wahrung der Unabh&#228;ngigkeit und Objektivit&#228;t wurden eingehalten.</Pgraph></TextBlock>
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