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Effect of long-chain polyunsaturated fatty acid supplementation of preterm infants on disease risk and neurodevelopment: a systematic review of randomized controlled trials.
Am J Clin Nutr 2008; 87(4):912-20AJ

Abstract

BACKGROUND

Supplementation of preterm formulas with long-chain polyunsaturated fatty acids (LCPUFAs) is based on their effectiveness to increase blood status and improve visual outcomes. Dispute remains over their efficacy on global development.

OBJECTIVE

The objective was to compare the effects of LCPUFA-supplemented with those of control formulas on neurodevelopment and diseases associated with prematurity.

DESIGN

We systematically reviewed randomized controlled trials involving preterm infants that tested LCPUFA-supplemented formulas. The weighted mean differences (WMDs) in neurodevelopmental scores and relative risk (RR) of disease were calculated to compare infants fed LCPUFA-supplemented formula with those fed control formula.

RESULTS

No clear differences in Bayley Scales of Infant Development (BSID) scores were observed between groups. Mental development of LCPUFA-supplemented infants was 3.4 points higher than that of control infants with BSID version II (WMD: 3.44; 95% CI: 0.56, 6.31; P = 0.02; n = 879), although it was driven by 2 trials with large effect sizes and wide CIs. Psychomotor development was lower in supplemented infants tested with BSID version I (WMD: -7.99; 95% CI: -14.00, -1.99; P = 0.009; n = 87); however, it was limited by small sample sizes. No differences in the RR of sepsis (1.08; 95% CI: 0.79, 1.46; P = 0.63; n = 1333) or in the RR of necrotizing enterocolitis (1.13; 95% CI: 0.62, 2.04; P = 0.69; n = 1333) were found. Similarly, the risks of retinopathy of prematurity, intraventricular hemorrhage, and bronchopulmonary dysplasia were not different between groups, but data were limited by small sample sizes and trials with an increased risk of bias.

CONCLUSIONS

LCPUFA-supplemented formula does not alter the risk of NEC or sepsis. Further work is needed to determine the extent of benefit of LCPUFA-supplemented formula on the mental development of preterm infants.

Authors+Show Affiliations

Child Health Research Institute, Child, Youth and Women's Health Service, North Adelaide, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

18400714

Citation

Smithers, Lisa G., et al. "Effect of Long-chain Polyunsaturated Fatty Acid Supplementation of Preterm Infants On Disease Risk and Neurodevelopment: a Systematic Review of Randomized Controlled Trials." The American Journal of Clinical Nutrition, vol. 87, no. 4, 2008, pp. 912-20.
Smithers LG, Gibson RA, McPhee A, et al. Effect of long-chain polyunsaturated fatty acid supplementation of preterm infants on disease risk and neurodevelopment: a systematic review of randomized controlled trials. Am J Clin Nutr. 2008;87(4):912-20.
Smithers, L. G., Gibson, R. A., McPhee, A., & Makrides, M. (2008). Effect of long-chain polyunsaturated fatty acid supplementation of preterm infants on disease risk and neurodevelopment: a systematic review of randomized controlled trials. The American Journal of Clinical Nutrition, 87(4), pp. 912-20.
Smithers LG, et al. Effect of Long-chain Polyunsaturated Fatty Acid Supplementation of Preterm Infants On Disease Risk and Neurodevelopment: a Systematic Review of Randomized Controlled Trials. Am J Clin Nutr. 2008;87(4):912-20. PubMed PMID: 18400714.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of long-chain polyunsaturated fatty acid supplementation of preterm infants on disease risk and neurodevelopment: a systematic review of randomized controlled trials. AU - Smithers,Lisa G, AU - Gibson,Robert A, AU - McPhee,Andrew, AU - Makrides,Maria, PY - 2008/4/11/pubmed PY - 2008/4/29/medline PY - 2008/4/11/entrez SP - 912 EP - 20 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 87 IS - 4 N2 - BACKGROUND: Supplementation of preterm formulas with long-chain polyunsaturated fatty acids (LCPUFAs) is based on their effectiveness to increase blood status and improve visual outcomes. Dispute remains over their efficacy on global development. OBJECTIVE: The objective was to compare the effects of LCPUFA-supplemented with those of control formulas on neurodevelopment and diseases associated with prematurity. DESIGN: We systematically reviewed randomized controlled trials involving preterm infants that tested LCPUFA-supplemented formulas. The weighted mean differences (WMDs) in neurodevelopmental scores and relative risk (RR) of disease were calculated to compare infants fed LCPUFA-supplemented formula with those fed control formula. RESULTS: No clear differences in Bayley Scales of Infant Development (BSID) scores were observed between groups. Mental development of LCPUFA-supplemented infants was 3.4 points higher than that of control infants with BSID version II (WMD: 3.44; 95% CI: 0.56, 6.31; P = 0.02; n = 879), although it was driven by 2 trials with large effect sizes and wide CIs. Psychomotor development was lower in supplemented infants tested with BSID version I (WMD: -7.99; 95% CI: -14.00, -1.99; P = 0.009; n = 87); however, it was limited by small sample sizes. No differences in the RR of sepsis (1.08; 95% CI: 0.79, 1.46; P = 0.63; n = 1333) or in the RR of necrotizing enterocolitis (1.13; 95% CI: 0.62, 2.04; P = 0.69; n = 1333) were found. Similarly, the risks of retinopathy of prematurity, intraventricular hemorrhage, and bronchopulmonary dysplasia were not different between groups, but data were limited by small sample sizes and trials with an increased risk of bias. CONCLUSIONS: LCPUFA-supplemented formula does not alter the risk of NEC or sepsis. Further work is needed to determine the extent of benefit of LCPUFA-supplemented formula on the mental development of preterm infants. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/18400714/Effect_of_long_chain_polyunsaturated_fatty_acid_supplementation_of_preterm_infants_on_disease_risk_and_neurodevelopment:_a_systematic_review_of_randomized_controlled_trials_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/87.4.912 DB - PRIME DP - Unbound Medicine ER -