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Tambahan kalsium dan fosforus kepada susu ibu untuk bayi lahir pramatang

Appendices

Appendix 1. Standard search methods

PubMed: ((infant, newborn[MeSH] OR newborn OR neonate OR neonatal OR premature OR low birth weight OR VLBW OR LBW or infan* or neonat*) AND (randomised controlled trial [pt] OR controlled clinical trial [pt] OR Clinical Trial[ptyp] OR randomised [tiab] OR placebo [tiab] OR clinical trials as topic [mesh: noexp] OR randomly [tiab] OR trial [ti]) NOT (animals [mh] NOT humans [mh]))

Embase: (infant, newborn or newborn or neonate or neonatal or premature or very low birth weight or low birth weight or VLBW or LBW or Newborn or infan* or neonat*) AND (human not animal) AND (randomised controlled trial or controlled clinical trial or randomised or placebo or clinical trials as topic or randomly or trial or clinical trial)

CINAHL: (infant, newborn OR newborn OR neonate OR neonatal OR premature OR low birth weight OR VLBW OR LBW or Newborn or infan* or neonat*) AND (randomised controlled trial OR controlled clinical trial OR randomised OR placebo OR clinical trials as topic OR randomly OR trial OR PT clinical trial)

Cochrane Library: (infant or newborn or neonate or neonatal or premature or very low birth weight or low birth weight or VLBW or LBW)

Study flow diagram (2016).
Figuras y tablas -
Figure 1

Study flow diagram (2016).

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 2

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.
Figuras y tablas -
Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 1 Weight (g).
Figuras y tablas -
Analysis 1.1

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 1 Weight (g).

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 2 Length (cm).
Figuras y tablas -
Analysis 1.2

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 2 Length (cm).

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 3 Head circumference (cm).
Figuras y tablas -
Analysis 1.3

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 3 Head circumference (cm).

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 4 Serum alkaline phosphatase.
Figuras y tablas -
Analysis 1.4

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 4 Serum alkaline phosphatase.

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 5 Osteopenia.
Figuras y tablas -
Analysis 1.5

Comparison 1 Calcium supplementation versus no calcium supplementation, Outcome 5 Osteopenia.

Summary of findings for the main comparison. Calcium supplementation compared with no calcium supplementation for preterm infants

Calcium supplementation compared with no calcium supplementation for preterm infants

Patient or population: preterm hospitalised infants
Setting: hospital setting
Intervention: calcium and/or phosphorus supplementation
Comparison: no supplement

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with no calcium/phosphorus supplementation

Risk with calcium/phosphorus supplementation

Weight (g) ‐ weight at 6 weeks

Mean weight (g) ‐ weight at 6 weeks was 2483 g

MD 138.5 g higher
(82.16 lower to 359.16 higher)

40
(1 RCT)

⊕⊕⊝⊝
Lowa,b

Length (cm) ‐ length at 6 weeks

Mean length (cm) ‐ length at 6 weeks was 47.04 cm

MD 0.77 cm higher
(0.93 lower to 2.47 higher)

40
(1 RCT)

⊕⊕⊝⊝
Lowa,c

Head circumference (cm) ‐ head circumference at 6 weeks

Mean head circumference (cm) ‐ head circumference at 6 weeks was 34.31 cm

MD 0.33 cm higher
(0.3 lower to 0.96 higher)

40
(1 RCT)

⊕⊕⊝⊝
Lowa,c

Bone fracture (neonatal) ‐ not measured

This was not a prespecified outcome; included study did not report this outcome

Growth (childhood/adulthood) ‐ not measured

Included study provided no follow‐up into childhood

Bone mineral density (infant/childhood/adulthood) ‐ not measured

Included study provided no follow‐up into childhood

Fracture (childhood/adulthood) ‐ not measured

Included study provided no follow‐up into childhood

*Risk in the intervention group (and its 95% confidence interval) is based on assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)

CI: confidence interval; OR: odds ratio; RR: risk ratio

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to the estimate of effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of effect but may be substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

aRisk of bias: insufficient evidence to judge methods of randomisation, allocation concealment or blinding of personnel ‐ downgraded one level

bImprecision: wide confidence intervals and data from a single small study ‐ downgraded one level

cImprecision: evidence from a single small study ‐ downgraded one level

Figuras y tablas -
Summary of findings for the main comparison. Calcium supplementation compared with no calcium supplementation for preterm infants
Comparison 1. Calcium supplementation versus no calcium supplementation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Weight (g) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 Weight at 2 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

52.5 [‐155.44, 260.44]

1.2 Weight at 4 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

60.00 [‐151.39, 271.39]

1.3 Weight at 6 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

138.5 [‐82.16, 359.16]

2 Length (cm) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 Length at 2 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

0.34 [‐1.36, 2.04]

2.2 Length at 4 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

0.47 [‐1.20, 2.14]

2.3 Length at 6 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

0.77 [‐0.93, 2.47]

3 Head circumference (cm) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 Head circumference at 2 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

0.19 [‐0.42, 0.80]

3.2 Head circumference at 4 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

0.22 [‐0.39, 0.83]

3.3 Head circumference at 6 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

0.33 [‐0.30, 0.96]

4 Serum alkaline phosphatase Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

4.1 Serum ALP at 2 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

‐36.35 [‐91.14, 18.44]

4.2 Serum ALP at 4 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

‐34.90 [‐81.23, 11.43]

4.3 Serum ALP at 6 weeks

1

40

Mean Difference (IV, Fixed, 95% CI)

‐56.85 [‐101.27, ‐12.43]

5 Osteopenia Show forest plot

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

0.62 [0.33, 1.15]

Figuras y tablas -
Comparison 1. Calcium supplementation versus no calcium supplementation