Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.
Ann Nutr Metab. 2011;58 Suppl 1:38-48. doi: 10.1159/000323465. Epub 2011 Jun 21.
This paper summarizes the literature concerning the effects of administering (1) long-chain polyunsaturated fatty acids (LCPUFA), (2) probiotics and/or (3) prebiotics to preterm infants. Clinically relevant, short- and long-term efficacy outcomes, such as those related to a reduced risk of disease, as well as outcomes related to safety, were sought. MEDLINE and the Cochrane Library literature searches performed in September 2010 were limited to randomized controlled trials, their systematic reviews or meta-analyses. LCPUFA supplementation, particularly docosahexaenoic acid (DHA), of infant formula for preterm infants has consistently demonstrated better visual development of preterm infants compared with unsupplemented formulas. There is increasing evidence to suggest that LCPUFA supplementation for preterm infants is also related to improvements in more global measures of development, without any adverse effects. It is, however, important to note that the DHA doses tested in the infant formula interventions for preterm infants have been rather conservative. Newer studies comparing dietary DHA concentrations that match in utero accumulation rates with dietary DHA concentrations typical in the milk of women consuming little fish or in supplemented infant formulas demonstrate that these higher DHA doses are related to improvements in domains of cognitive development. Although further work is needed to better understand the optimal DHA requirements of preterm infants, it is clear that a dietary source of DHA is important to support neurodevelopment. To date, the most promising application of probiotics in preterm infants is the prevention of necrotizing enterocolitis by the administration of certain probiotics. Many other benefits of administering probiotics and/or prebiotics to preterm infants are, however, largely unproven. Efficacy and safety should be established for each probiotic and/or prebiotic product. Further research should specify strain-specific outcomes and determine optimal dosing schedules. Safety and long-term follow-up studies are of particular interest.
本文总结了关于给早产儿施用（1）长链多不饱和脂肪酸（LCPUFA）、（2）益生菌和/或（3）益生元的文献。寻找与疾病风险降低相关的临床相关短期和长期疗效结果，以及与安全性相关的结果。2010 年 9 月进行的 MEDLINE 和 Cochrane 图书馆文献检索仅限于随机对照试验、系统评价或荟萃分析。与未补充配方相比，早产儿配方奶粉中 LCPUFA（特别是二十二碳六烯酸[DHA]）的补充始终显示出对早产儿视觉发育的改善。越来越多的证据表明，LCPUFA 补充剂也与早产儿更全面的发育措施的改善有关，而没有任何不良影响。然而，重要的是要注意，在早产儿配方奶粉干预中测试的 DHA 剂量相当保守。一些更新的研究比较了饮食 DHA 浓度与胎儿积累率相匹配的情况，以及与食用很少鱼类的妇女的母乳中或补充婴儿配方中的典型 DHA 浓度相匹配的情况，结果表明这些更高的 DHA 剂量与认知发育领域的改善有关。尽管还需要进一步的工作来更好地了解早产儿的最佳 DHA 需求，但很明显，饮食中的 DHA 来源对于支持神经发育很重要。迄今为止，益生菌在早产儿中的最有前途的应用是通过给予某些益生菌来预防坏死性小肠结肠炎。然而，给早产儿施用益生菌和/或益生元的许多其他益处在很大程度上尚未得到证实。应该为每种益生菌和/或益生元产品确定疗效和安全性。进一步的研究应该具体说明特定菌株的结果，并确定最佳剂量方案。安全性和长期随访研究特别有趣。
