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Обогащенная питательными веществами молочная смесь (формула) по сравнению со стандартной смесью (формулой) для недоношенных детей после выписки из стационара

Información

DOI:
https://doi.org/10.1002/14651858.CD004696.pub5Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 13 diciembre 2016see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:
  1. Grupo Cochrane de Neonatología

Copyright:
  1. Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Contraer

Autores

  • Lauren Young

    Paediatric Intensive Care Unit, Birmingham Children's Hospital, Birmingham, UK

  • Nicholas D Embleton

    Newcastle Neonatal Service, Newcastle Hospitals NHS Foundation Trust and University of Newcastle, Newcastle upon Tyne, UK

  • William McGuire

    Correspondencia a: Centre for Reviews and Dissemination, York, UK

    [email protected]

Contributions of authors

William McGuire and Lauren Young undertook the electronic search and identified citations for possible inclusion. Lauren Young, William McGuire and Nick Embleton reviewed the citation list (title and abstract) for inclusion and undertook methodological appraisal and data extraction, entry and analysis. William McGuire acted as an arbiter for disagreements, reviewed data entered and analysed and completed the review.

Sources of support

Internal sources

  • Centre for Reviews and Dissemination, University of York, UK.

  • Royal Victoria Infirmary, Newcastle upon Tyne, UK.

External sources

  • NIHR, UK.

    This report is independent research funded by a UK National Institute of Health Research Grant (NIHR) Cochrane Programme Grant (13/89/12). The views expressed in this publication are those of the review authors and are not necessarily those of the NHS, the NIHR or the UK Department of Health.

  • Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, USA.

    Editorial support of the Cochrane Neonatal Review Group has been provided by Federal funds from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, USA, under Contract No. HHSN275201600005C.

Declarations of interest

Nick Embleton has conducted research with support from manufacturers of infant formula including Nestec SA (Switzerland), Wyeth UK and Nutricia UK, but did not receive payment, support nor benefit in kind for contributions to this review.

Acknowledgements

We thank Dr Litmanovitz for clarifying aspects of Litmanovitz 2004.

We thank Dr Roggero for kindly providing unpublished data from Roggero 2011 for inclusion in this review.

We thank Yolanda Brosseau and Colleen Ovelman of the Cochrane Neonatal Review Group for help in preparing this updated review.

Editorial support of the Cochrane Neonatal Review Group has been provided with Federal funds from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, USA, under Contract No. HHSN275201100016C.

Version history

Published

Title

Stage

Authors

Version

2016 Dec 13

Nutrient‐enriched formula versus standard formula for preterm infants following hospital discharge

Review

Lauren Young, Nicholas D Embleton, William McGuire

https://doi.org/10.1002/14651858.CD004696.pub5

2012 Mar 14

Nutrient‐enriched formula versus standard term formula for preterm infants following hospital discharge

Review

Lauren Young, Jessie Morgan, Felicia M McCormick, William McGuire

https://doi.org/10.1002/14651858.CD004696.pub4

2007 Oct 17

Nutrient‐enriched formula versus standard term formula for preterm infants following hospital discharge

Review

Ginny Henderson, Tom Fahey, William McGuire

https://doi.org/10.1002/14651858.CD004696.pub3

2005 Apr 20

Calorie and protein‐enriched formula versus standard term formula for improving growth and development in preterm or low birth weight infants following hospital discharge

Review

Ginny Henderson, Tom Fahey, William McGuire

https://doi.org/10.1002/14651858.CD004696.pub2

2004 Apr 19

Calorie and protein‐enriched formula versus standard term formula for improving growth and development in preterm or low birth weight infants following hospital discharge

Protocol

William McGuire, Tom Fahey

https://doi.org/10.1002/14651858.CD004696

Differences between protocol and review

We added the methods and plan for Summary of findings tables and GRADE recommendations, which were not included in the original protocol nor in the previously published review.

Keywords

MeSH

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Study flow diagram: review update.
Figuras y tablas -
Figure 1

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.
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.

Forest plot of comparison: 1 Postdischarge formula versus standard term formula, outcome: 1.2 Weight (grams).
Figuras y tablas -
Figure 3

Forest plot of comparison: 1 Postdischarge formula versus standard term formula, outcome: 1.2 Weight (grams).

Forest plot of comparison: 1 Postdischarge formula versus standard term formula, outcome: 1.3 Crown‐heel length (mm).
Figuras y tablas -
Figure 4

Forest plot of comparison: 1 Postdischarge formula versus standard term formula, outcome: 1.3 Crown‐heel length (mm).

Forest plot of comparison: 1 Postdischarge formula versus standard term formula, outcome: 1.4 Head circumference (mm).
Figuras y tablas -
Figure 5

Forest plot of comparison: 1 Postdischarge formula versus standard term formula, outcome: 1.4 Head circumference (mm).

Forest plot of comparison: 2 Preterm formula versus standard term formula, outcome: 2.2 Weight (grams).
Figuras y tablas -
Figure 6

Forest plot of comparison: 2 Preterm formula versus standard term formula, outcome: 2.2 Weight (grams).

Forest plot of comparison: 2 Preterm formula versus standard term formula, outcome: 2.3 Crown‐heel length (mm).
Figuras y tablas -
Figure 7

Forest plot of comparison: 2 Preterm formula versus standard term formula, outcome: 2.3 Crown‐heel length (mm).

Forest plot of comparison: 2 Preterm formula versus standard term formula, outcome: 2.4 Head circumference (mm).
Figuras y tablas -
Figure 8

Forest plot of comparison: 2 Preterm formula versus standard term formula, outcome: 2.4 Head circumference (mm).

Comparison 1 Postdischarge formula versus standard term formula, Outcome 1 Growth rates during trial period.
Figuras y tablas -
Analysis 1.1

Comparison 1 Postdischarge formula versus standard term formula, Outcome 1 Growth rates during trial period.

Comparison 1 Postdischarge formula versus standard term formula, Outcome 2 Weight (grams).
Figuras y tablas -
Analysis 1.2

Comparison 1 Postdischarge formula versus standard term formula, Outcome 2 Weight (grams).

Comparison 1 Postdischarge formula versus standard term formula, Outcome 3 Crown‐heel length (mm).
Figuras y tablas -
Analysis 1.3

Comparison 1 Postdischarge formula versus standard term formula, Outcome 3 Crown‐heel length (mm).

Comparison 1 Postdischarge formula versus standard term formula, Outcome 4 Head circumference (mm).
Figuras y tablas -
Analysis 1.4

Comparison 1 Postdischarge formula versus standard term formula, Outcome 4 Head circumference (mm).

Comparison 1 Postdischarge formula versus standard term formula, Outcome 5 Development.
Figuras y tablas -
Analysis 1.5

Comparison 1 Postdischarge formula versus standard term formula, Outcome 5 Development.

Comparison 1 Postdischarge formula versus standard term formula, Outcome 6 Bone mineralisation.
Figuras y tablas -
Analysis 1.6

Comparison 1 Postdischarge formula versus standard term formula, Outcome 6 Bone mineralisation.

Comparison 2 Preterm formula versus standard term formula, Outcome 1 Growth rates during trial period.
Figuras y tablas -
Analysis 2.1

Comparison 2 Preterm formula versus standard term formula, Outcome 1 Growth rates during trial period.

Comparison 2 Preterm formula versus standard term formula, Outcome 2 Weight (grams).
Figuras y tablas -
Analysis 2.2

Comparison 2 Preterm formula versus standard term formula, Outcome 2 Weight (grams).

Comparison 2 Preterm formula versus standard term formula, Outcome 3 Crown‐heel length (mm).
Figuras y tablas -
Analysis 2.3

Comparison 2 Preterm formula versus standard term formula, Outcome 3 Crown‐heel length (mm).

Comparison 2 Preterm formula versus standard term formula, Outcome 4 Head circumference (mm).
Figuras y tablas -
Analysis 2.4

Comparison 2 Preterm formula versus standard term formula, Outcome 4 Head circumference (mm).

Comparison 2 Preterm formula versus standard term formula, Outcome 5 Development.
Figuras y tablas -
Analysis 2.5

Comparison 2 Preterm formula versus standard term formula, Outcome 5 Development.

Summary of findings for the main comparison. Postdischarge formula compared with standard term formula for preterm infants after hospital discharge

Postdischarge formula compared with standard term formula for preterm infants after hospital discharge

Patient or population: preterm infants after hospital discharge
Setting: community
Intervention: postdischarge formula
Comparison: standard term formula

Outcomes

Anticipated absolute effects*

(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Postdischarge formula vs standard term formula

Weight (grams) 3‐4 months post term

MD 7.45 g lower
(141.84 lower to 126.93 higher)

523
(6 RCTs)

⊕⊕⊕⊝
Moderate

Downgraded for moderate inconsistency (I² = 62%)

Weight (grams) 6 months post term

MD 35.54 g higher
(113.71 lower to 184.78 higher)

576
(7 studies)

⊕⊕⊕⊝
Moderate

Downgraded for inconsistency moderate (I² = 64%).

Crown‐heel length (mm) 3‐4 months post term

MD 2.45 mm higher
(2.01 lower to 6.9 higher)

523
(6 RCTs)

⊕⊕⊕⊝
Moderate

Downgraded for high inconsistency (I² = 81%)

Crown‐heel length (mm) 6 months post term

MD 2.12 mm higher
(2.16 lower to 6.41 higher)

576
(7 studies)

⊕⊕⊕⊝
Moderate

Downgraded for moderate inconsistency (I² = 75%)

Head circumference (mm) 3‐4 months post term

MD 0.3 mm lower
(2.86 lower to 2.26 higher)

523
(6 studies)

⊕⊕⊕⊝
Moderate

Downgraded for moderate inconsistency (I² = 71%)

Head circumference (mm) 6 months post term

MD 2.28 mm higher
(0.28 lower to 4.83 higher)

576
(7 studies)

⊕⊕⊕⊝
Moderate

Downgraded for moderate inconsistency (I² = 69%)

Development ‐ Bayley Scales of Infant Development II: Mental Development Index

MD 0.9 higher
(3.24 lower to 5.04 higher)

184
(1 RCT)

⊕⊕⊕⊕
High

Figuras y tablas -
Summary of findings for the main comparison. Postdischarge formula compared with standard term formula for preterm infants after hospital discharge
Summary of findings 2. Preterm formula compared with standard term formula for preterm infants after hospital discharge

Preterm formula compared with standard term formula for preterm infants after hospital discharge

Patient or population: preterm infants after hospital discharge
Setting: community
Intervention: preterm formula
Comparison: standard term formula

Outcomes

Anticipated absolute effects* (95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Preterm formula vs standard term formula

Weight (grams) 3‐4 months post term

MD 74.41 g higher
(267.1 lower to 415.93 higher)

130
(3 RCTs)

⊕⊕⊕⊝
Moderate

Downgraded for imprecision

Weight (grams) 6 months post term

MD 74.6 g higher
(164.73 lower to 313.92 higher)

273
(4 RCTs)

⊕⊕⊕⊝
Moderate

Downgraded for imprecision

Crown‐heel length (mm) 3‐4 months post term

MD 2.27 mm lower
(13.09 lower to 8.56 higher)

130
(3 RCTs)

⊕⊕⊕⊝
Moderate

Downgraded for imprecision

Crown‐heel length (mm) 6 months post term

MD 1.83 mm higher
(6.25 lower to 9.92 higher)

160
(3 RCTs)

⊕⊕⊕⊝
Moderate

Downgraded for imprecision

Head circumference (mm) 3‐4 months post term

MD 3.61 mm higher
(2.09 lower to 9.31 higher)

130
(3 RCTs)

⊕⊕⊕⊝
Moderate

Downgraded for imprecision

Head circumference (mm) 6 months post term

MD 5.82 mm higher
(1.32 higher to 10.32 higher)

160
(3 RCTs)

⊕⊕⊕⊝
Moderate

Downgraded for imprecision

Development ‐ Bayley Scales of Infant Development II: Mental Development Index

MD 1.44 lower
(6.22 lower to 3.35 higher)

143
(2 RCTs)

⊕⊕⊕⊕
High

Figuras y tablas -
Summary of findings 2. Preterm formula compared with standard term formula for preterm infants after hospital discharge
Comparison 1. Postdischarge formula versus standard term formula

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Growth rates during trial period Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 Weight gain (g/kg/d)

1

33

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐1.37, 1.37]

1.2 Linear growth (mm/wk)

1

33

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐1.07, 1.07]

1.3 Head circumference (mm/wk)

1

33

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.68, 0.68]

2 Weight (grams) Show forest plot

7

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 3‐4 months post term

6

523

Mean Difference (IV, Fixed, 95% CI)

‐7.45 [‐141.84, 126.93]

2.2 6 months post term

7

576

Mean Difference (IV, Fixed, 95% CI)

35.54 [‐113.71, 184.78]

2.3 9 months post term

4

347

Mean Difference (IV, Fixed, 95% CI)

244.09 [16.95, 471.23]

2.4 12 months post term

4

314

Mean Difference (IV, Fixed, 95% CI)

‐14.87 [‐243.18, 213.43]

2.5 18‐24 months post term

1

192

Mean Difference (IV, Fixed, 95% CI)

100.0 [‐246.90, 446.90]

3 Crown‐heel length (mm) Show forest plot

7

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 3‐4 months post term

6

523

Mean Difference (IV, Fixed, 95% CI)

2.45 [‐2.01, 6.90]

3.2 6 months post term

7

576

Mean Difference (IV, Fixed, 95% CI)

2.12 [‐2.16, 6.41]

3.3 9 months post term

4

347

Mean Difference (IV, Fixed, 95% CI)

7.33 [1.80, 12.87]

3.4 12 months post term

4

314

Mean Difference (IV, Fixed, 95% CI)

‐0.66 [‐6.43, 5.10]

3.5 18‐24 months post term

1

192

Mean Difference (IV, Fixed, 95% CI)

9.0 [0.32, 17.68]

4 Head circumference (mm) Show forest plot

7

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

4.1 3‐4 months post term

6

523

Mean Difference (IV, Fixed, 95% CI)

‐0.30 [‐2.86, 2.26]

4.2 6 months post term

7

576

Mean Difference (IV, Fixed, 95% CI)

2.28 [‐0.28, 4.83]

4.3 9 months post term

4

347

Mean Difference (IV, Fixed, 95% CI)

0.16 [‐3.21, 3.53]

4.4 12 months post term

4

314

Mean Difference (IV, Fixed, 95% CI)

2.11 [‐1.52, 5.75]

4.5 18‐24 months post term

1

192

Mean Difference (IV, Fixed, 95% CI)

‐3.0 [‐8.24, 2.24]

5 Development Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 Bayley Scales of Infant Development II: Mental Development Index

1

184

Mean Difference (IV, Fixed, 95% CI)

0.90 [‐3.24, 5.04]

5.2 Bayley Scales of Infant Development II: Psychomotor Development Index

1

184

Mean Difference (IV, Fixed, 95% CI)

2.70 [‐1.28, 6.68]

6 Bone mineralisation Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 Bone area at 2 months post term (cm2)

1

33

Mean Difference (IV, Fixed, 95% CI)

7.0 [‐15.46, 29.46]

6.2 Bone mineral content at 2 months post term (grams)

1

33

Mean Difference (IV, Fixed, 95% CI)

3.20 [‐4.73, 11.13]

6.3 Bone 'speed of sound' assessed on ultrasonography at 6 months post term (mm/s)

1

20

Mean Difference (IV, Fixed, 95% CI)

45.0 [‐18.48, 108.48]

6.4 Bone specific serum alkaline phosphatase at 6 months post term (units/L)

1

20

Mean Difference (IV, Fixed, 95% CI)

‐9.0 [‐42.01, 24.01]

6.5 Bone width at 9 months post term (cm)

1

31

Mean Difference (IV, Fixed, 95% CI)

0.05 [‐0.01, 0.11]

6.6 Bone mineral content at 9 months post term (mg/cm)

1

31

Mean Difference (IV, Fixed, 95% CI)

20.60 [7.78, 33.42]

Figuras y tablas -
Comparison 1. Postdischarge formula versus standard term formula
Comparison 2. Preterm formula versus standard term formula

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Growth rates during trial period Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 Weight gain (g/d)

1

42

Mean Difference (IV, Fixed, 95% CI)

3.70 [‐0.16, 7.56]

1.2 Linear growth (mm/wk)

1

42

Mean Difference (IV, Fixed, 95% CI)

1.0 [0.09, 1.91]

1.3 Head circumference (mm/wk)

1

42

Mean Difference (IV, Fixed, 95% CI)

0.5 [‐0.04, 1.04]

2 Weight (grams) Show forest plot

5

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 3‐4 months post term

3

130

Mean Difference (IV, Fixed, 95% CI)

74.41 [‐267.10, 415.93]

2.2 6 months post term

4

273

Mean Difference (IV, Fixed, 95% CI)

74.60 [‐164.73, 313.92]

2.3 9 months post term

1

59

Mean Difference (IV, Fixed, 95% CI)

112.0 [‐482.69, 706.69]

2.4 12 months post term

4

265

Mean Difference (IV, Fixed, 95% CI)

539.48 [255.03, 823.92]

2.5 18 months post term

2

162

Mean Difference (IV, Fixed, 95% CI)

490.81 [142.19, 839.44]

3 Crown‐heel length (mm) Show forest plot

5

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 3‐4 months post term

3

130

Mean Difference (IV, Fixed, 95% CI)

‐2.27 [‐13.09, 8.56]

3.2 6 months post term

3

160

Mean Difference (IV, Fixed, 95% CI)

1.83 [‐6.25, 9.92]

3.3 9 months post term

1

59

Mean Difference (IV, Fixed, 95% CI)

‐3.0 [‐17.03, 11.03]

3.4 12 months post term

3

152

Mean Difference (IV, Fixed, 95% CI)

5.13 [‐4.23, 14.49]

3.5 18 months post term

2

162

Mean Difference (IV, Fixed, 95% CI)

11.00 [1.89, 20.11]

4 Head circumference (mm) Show forest plot

5

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

4.1 3‐4 months post term

3

130

Mean Difference (IV, Fixed, 95% CI)

3.61 [‐2.09, 9.31]

4.2 6 months post term

3

160

Mean Difference (IV, Fixed, 95% CI)

5.82 [1.32, 10.32]

4.3 9 months post term

1

59

Mean Difference (IV, Fixed, 95% CI)

8.0 [0.85, 15.15]

4.4 12 months post term

3

152

Mean Difference (IV, Fixed, 95% CI)

6.07 [1.07, 11.06]

4.5 18 months post term

2

162

Mean Difference (IV, Fixed, 95% CI)

5.42 [0.69, 10.14]

5 Development Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 Bayley Scales of Infant Development II: Mental Development Index

2

143

Mean Difference (IV, Fixed, 95% CI)

‐1.44 [‐6.22, 3.35]

5.2 Bayley Scales of Infant Development II: Psychomotor Development Index

2

143

Mean Difference (IV, Fixed, 95% CI)

‐1.13 [‐4.19, 1.93]

Figuras y tablas -
Comparison 2. Preterm formula versus standard term formula