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Intervention Review

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

  1. Ginny Henderson2,
  2. Tom Fahey3,
  3. William McGuire1,*

Editorial Group: Cochrane Neonatal Group

Published Online: 17 OCT 2007

Assessed as up-to-date: 24 JUN 2007

DOI: 10.1002/14651858.CD004696.pub3


How to Cite

Henderson G, Fahey T, McGuire W. Nutrient-enriched formula versus standard term formula for preterm infants following hospital discharge. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD004696. DOI: 10.1002/14651858.CD004696.pub3.

Author Information

  1. 1

    Australian National University Medical School, Department of Paediatrics and Child Health, Canberra, ACT 2606, Australia

  2. 2

    Griffith University, School of Nursing and Midwifery, South Brisbane, Queensland, Australia

  3. 3

    Royal College of Surgeons in Ireland Medical School, Department of Family Medicine and General Practice, Dublin, Ireland

*William McGuire, Department of Paediatrics and Child Health, Australian National University Medical School, Canberra Hospital Campus, Canberra, ACT 2606, Australia. william.mcguire@act.gov.au.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 17 OCT 2007

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Preterm infants are often growth-restricted at hospital discharge. Feeding infants after hospital discharge with nutrient-enriched formula rather than standard term formula might facilitate "catch-up" growth and improve development.

Objectives

To determine the effect of feeding nutrient-enriched formula compared with standard term formula on growth and development for preterm infants following hospital discharge.

Search methods

The standard search strategy of the Cochrane Neonatal Review Group were used. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2007), MEDLINE (1966 - May 2007), EMBASE (1980 - May 2007), CINAHL (1982 - May 2007), conference proceedings, and previous reviews.

Selection criteria

Randomised or quasi-randomised controlled trials that compared the effect of feeding preterm infants following hospital discharge with nutrient-enriched formula compared with standard term formula.

Data collection and analysis

Data was extracted using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by two authors, and synthesis of data using weighted mean difference and a fixed effects model for meta-analysis.

Main results

Seven trials were found that were eligible for inclusion. These recruited a total of 631 infants and were generally of good methodological quality. The trials found little evidence that feeding with nutrient-enriched formula milk affected growth and development. Because of differences in the way individual trials measured and presented outcomes, data synthesis was limited. Growth data from two trials found that, at six months post-term, infants fed with nutrient-enriched formula had statistically significantly lower weights [weighted mean difference: -601 (95% confidence interval -1028, -174) grams], lengths [-18.8 (-30.0, -7.6) millimetres], and head circumferences [-10.2 ( -18.0, -2.4) millimetres], than infants fed standard term formula. At 12 to 18 months post-term, meta-analyses of data from three trials did not find any statistically significant differences in growth parameters. However, examination of these meta-analyses demonstrated statistical heterogeneity. Meta-analyses of data from two trials did not reveal a statistically significant difference in Bayley Mental Development or Psychomotor Development Indices. There are not yet any data on growth or development through later childhood.

Authors' conclusions

The available data do not provide strong evidence that feeding preterm infants following hospital discharge with nutrient-enriched formula compared with standard term formula affects growth rates or development up to 18 months post-term.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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

Preterm infants are often much smaller than term infants by the time that they are discharged home from hospital. This review attempted to identify evidence that feeding these infants with formula milk enriched with nutrients rather than ordinary formula designed for term infants, would increase growth rates and benefit development. Seven good quality trials were identified. These trials provided little evidence that unrestricted feeding with nutrient-enriched formula milk affects growth and development up to about 18 months of age. Long-term growth and development has not yet been assessed. Further randomised controlled trials are needed to address this question.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

早產兒在出院後使用加強營養的配方奶或標準足月配方奶

早產兒通常在出院後仍呈現生長受限的狀態。餵哺出院後的早產兒加強營養配方奶而非標準足月配方奶,也許可以加速其成長及改善發展。

目標

為了決定餵哺加強營養配方奶及標準足月配方奶在出院後早產兒的生長及發展上的影響。

搜尋策略

使用Cochrane Neonatal Review Group的標準搜尋策略。這包括搜尋Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2007), MEDLINE (1966  May 2007), EMBASE (1980 May 2007), CINAHL (1982  May 2007), 會議記錄及之前的回顧文章。

選擇標準

選擇有關比較餵哺出院後早產兒加強營養配方奶,或標準足月配方奶之隨機分配或半隨機分配的文章。

資料收集與分析

使用Cochrane Neonatal Review Group的標準方法,藉兩位回顧文章作者來分開評估其研究品質及資料的選取。資料的整理是採加重平均差異性,並設定一個固定影響的模式來做統合分析(meta analysis)。

主要結論

總共有七個試驗符合條件。共包含631個嬰孩,且這些都符合良好的收案品質。這些試驗中有証據顯示餵哺加強營養配方能影響生長及發展。因為不同試驗檢測的項目及呈現的預後不同,資料分析會因此受限。在兩個試驗中發現餵哺營養加強配方奶的寶寶在矯正年齡6個月時,其體重[平均標準差: −601 (95% 信賴區間1028, −174) 克]、身長[−18.8 (−30.0, −7.6) mm]及頭圍[−10.2 (−18.0, −2.4) mm],在統計學上顯著低於餵食標準足月配方奶的寶寶。在矯正年齡12到18個月大時,三個試驗中的後納分析顯示並無顯示在生長上有統計學上的差異。然而,這些統合分析顯示統計學上顯著的差異性。統合分析中的兩項試驗中顯示在貝利發展指數上(Bayley Mental Development or Psychomotor Development Indices)並沒有顯著差異。關於孩童時期的的生長及發展並沒有相關資料。

作者結論

可獲得的資料顯示並沒有強烈證據證明餵哺出院早產兒加強營養配方奶,比餵哺足月產配方奶,在18個月前會影響生長速度及發展。

翻譯人

本摘要由馬偕醫院曾至凡翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

當出院回家時,早產兒通常比足月兒小很多。這回顧想證明在這些嬰兒餵哺加強營養配方奶比哺餵標準足月配方奶有較好的生長及發展。總共有七個良好的試驗符合條件,但獲得的資料顯示並沒有強烈證據證明餵哺出院早產兒加強營養配方奶,在18個月前會影響生長速度及發展。長期的生長發育的評估需要進一步隨機分配試驗來解答。