Wang Qian, Cui Qiliang, Yan Caiman
Department of Pediatrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Department of Pediatrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Pediatr Neurol. 2016 Jun;59:54-61.e1. doi: 10.1016/j.pediatrneurol.2016.02.017. Epub 2016 Mar 5.
Long-chain polyunsaturated fatty acids, especially docosahexaenoic acid, have been suggested as a nutrition factor affecting visual and neurobehavioral development of preterm infants. Several randomized controlled trials (RCTs) have investigated the effect of supplementation of long-chain polyunsaturated fatty acids on preterm infants. We conducted a systematic review and meta-analysis to examine the efficacy of long-chain polyunsaturated fatty acid supplementation of formula or breast milk on the neurodevelopment outcomes of preterm infants.
Two authors searched PubMed and Cochrane Library (CENTRAL) for RCTs assessing efficacy of long-chain polyunsaturated fatty acids supplementation on the neurobehavioral and development outcomes of preterm infant. Human RCTs which supplemented long-chain polyunsaturated fatty acids during lactation and assessed neurodevelopment were included. The quality of each RCT was assessed, and the results of eligible trials were included in the systematic review and meta-analysis.
We included 11 RCTs with 2272 total participants. Methodologic limitations existed to some extent in most RCTs that were included. Because the age of the participants from different trails was not the same, different scales and indexes had been assessed from different RCTs. Our meta-analysis indicated a significant effect of long-chain polyunsaturated fatty acids supplementation on the neurodevelopment of preterm infants assessed by the Mental Development Index of the Bayley Scales at one to three years of age versus the control groups.
Analysis of our consolidated data indicates that long-chain fatty acid supplementation results in a significant improvement in the neurodevelopment of preterm infants as assessed by the Mental Development Index at one to three years of age. The available evidence suggests that long-chain polyunsaturated fatty acid supplementation during lactation may accelerate the pace of neurodevelopment in preterm infants, although their final developmental outcome may be unchanged.
长链多不饱和脂肪酸，尤其是二十二碳六烯酸，被认为是影响早产儿视觉和神经行为发育的营养因素。多项随机对照试验（RCT）研究了补充长链多不饱和脂肪酸对早产儿的影响。我们进行了一项系统评价和荟萃分析，以检验在配方奶或母乳中补充长链多不饱和脂肪酸对早产儿神经发育结局的疗效。
两位作者检索了PubMed和Cochrane图书馆（CENTRAL），以查找评估补充长链多不饱和脂肪酸对早产儿神经行为和发育结局疗效的RCT。纳入在哺乳期补充长链多不饱和脂肪酸并评估神经发育的人体RCT。评估每个RCT的质量，并将符合条件的试验结果纳入系统评价和荟萃分析。
我们纳入了11项RCT，共有2272名参与者。纳入的大多数RCT在一定程度上存在方法学局限性。由于不同试验的参与者年龄不同，不同的RCT评估了不同的量表和指标。我们的荟萃分析表明，与对照组相比，补充长链多不饱和脂肪酸对1至3岁时通过贝利量表智力发育指数评估的早产儿神经发育有显著影响。
对我们汇总数据的分析表明，补充长链脂肪酸可使1至3岁时通过智力发育指数评估的早产儿神经发育有显著改善。现有证据表明，哺乳期补充长链多不饱和脂肪酸可能会加快早产儿的神经发育速度，尽管他们的最终发育结局可能不变。
