早産児の成長を促進するための母乳の脂肪分補充
Información
- DOI:
- https://doi.org/10.1002/14651858.CD000341.pub2Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 19 junio 2018see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Neonatología
- Copyright:
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- Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Emma Amissah assessed study eligibility, performed data extraction and ’Risk of bias’ assessment of included studies, analysed data, interpreted results of the analysis, and updated the review. She wrote all drafts and addressed comments from co‐authors.
Julie Brown assessed study eligibility, performed data extraction and ’Risk of bias’ assessment of included studies, assisted in the interpretation of analyses, and provided comments on drafts.
Jane Harding answered queries on trial eligibility, assisted in the interpretation of analyses, and provided comments on all drafts of the review.
All authors read and approved the final version of the review.
Sources of support
Internal sources
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Liggins Institute, The University of Auckland, Auckland, New Zealand.
External sources
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We acknowledge the support from the Australian and New Zealand Pregnancy and Childbirth Satellite at the Liggins Institute, The University of Auckland, New Zealand.
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National Institute for Health Research, UK.
Editorial support for Cochrane Neonatal has been funded with funds from a UK National Institute of Health Research (NIHR) Cochrane Programme Grant (16/114/03). The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, the NIHR or the UK Department of Health.
Declarations of interest
Emma Amissah: None known.
Julie Brown: None known.
Jane Harding: None known.
Acknowledgements
Emma Amissah was supported by a doctoral scholarship from the University of Auckland.
Julie Brown was supported by a grant from the Health Research Council of New Zealand.
We acknowledge the support of Caroline A Crowther in preparing this review, and the work of Carl A Kuschel as lead author of the original review (Kuschel 2000).
The methods section of this review is based on a standard template used by Cochrane Neonatal.
Version history
| Published | Title | Stage | Authors | Version |
| 2020 Aug 25 | Fat supplementation of human milk for promoting growth in preterm infants | Review | Emma A Amissah, Julie Brown, Jane E Harding | |
| 2018 Jun 19 | Fat supplementation of human milk for promoting growth in preterm infants | Review | Emma A Amissah, Julie Brown, Jane E Harding | |
| 2000 Apr 24 | Fat supplementation of human milk for promoting growth in preterm infants | Review | Carl A Kuschel, Jane E Harding, Vazhkudai S Kumaran | |
Differences between protocol and review
The original protocol was published in 1997, and was the basis of the last version of this review written in 2000. This update aligned the review outcomes with those of the Cochrane Review, Multi‐nutrient fortification of human milk for preterm infants (Brown 2016). We added body mass index and measures of body composition as part of growth parameters of the primary outcome. We also included new secondary outcome measures: long‐term measures of cardio‐metabolic health (such as insulin resistance, obesity, diabetes, and hypertension) We also added the 'Summary of Findings' tables and GRADE recommendations, which were not included in the original protocol.
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Humans; Infant, Newborn;
PICO
81, Study flow diagram: review update
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Comparison 1 Fat supplementation vs control, Outcome 1 Growth ‐ weight.
Comparison 1 Fat supplementation vs control, Outcome 2 Growth ‐ length.
Comparison 1 Fat supplementation vs control, Outcome 3 Growth ‐ head circumference.
Comparison 1 Fat supplementation vs control, Outcome 4 Feeding intolerance.
| Fat supplementation compared to control for promoting growth in preterm infants | ||||||
| Patient or population: preterm infants | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect | № of participants | Quality of the evidence | Comments | |
| Risk with control | Risk with Fat supplementation | |||||
| Growth ‐ weight ‐ weight gain (g/kg/day) | The mean weight gain in the unsupplemented human milk group was 15.3 g/kg/day. | MD 0.6 g/kg/day higher | ‐ | 14 | ⊕⊝⊝⊝ | |
| Growth ‐ length ‐ length gain (cm/week) | The mean length gain in the unsupplemented human milk group was 0.8 cm/week. | MD 0.1 cm/week higher | ‐ | 14 | ⊕⊝⊝⊝ | |
| Growth ‐ head circumference ‐ head growth (cm/week) | The mean head growth in the unsupplemented human milk group was 0.9 cm/week. | MD 0.2 cm/week higher | ‐ | 14 | ⊕⊝⊝⊝ | |
| Neurodevelopmental outcomes | ‐ | ‐ | ‐ | ‐ | ‐ | None of the included studies reported on neurodevelopmental outcomes. |
| Duration of hospital admission (days) | ‐ | ‐ | ‐ | ‐ | ‐ | None of the included studies reported on duration of hospital admission. |
| Feeding intolerance | 0 per 1000 | 0 per 1000 | RR 3.00 | 16 | ⊕⊝⊝⊝ | . |
| Necrotising enterocolitis | ‐ | ‐ | ‐ | ‐ | ‐ | None of the included studies reported on necrotising enterocolitis. |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Risk of bias: most of the trials lacked methodological details so that we were unable to judge risk of bias. This could have an impact on assessment of growth parameters and possibly the estimate of effect. Single trial. We downgraded one level. 2 Imprecision: few patients and wide confidence intervals, which included meaningful benefit and harm. Single trial. We downgraded two levels. 3 Imprecision: few patients, few events and wide confidence intervals, which include meaningful benefit and harm. Single trial. We downgraded two levels. | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Growth ‐ weight Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 1.1 Weight gain (g/kg/day) | 1 | 14 | Mean Difference (IV, Fixed, 95% CI) | 0.60 [‐2.36, 3.56] |
| 1.2 Weight at end of study (g) | 1 | 14 | Mean Difference (IV, Fixed, 95% CI) | 40.0 [‐258.62, 338.62] |
| 2 Growth ‐ length Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 2.1 Length gain (cm/week) | 1 | 14 | Mean Difference (IV, Fixed, 95% CI) | 0.10 [‐0.08, 0.28] |
| 3 Growth ‐ head circumference Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 3.1 Head growth (cm/week) | 1 | 14 | Mean Difference (IV, Fixed, 95% CI) | 0.15 [‐0.07, 0.37] |
| 4 Feeding intolerance Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Subtotals only | |
