Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Canada Nutrition Services, Alberta Health Services, Calgary, Alberta, Canada.
Departments of Nutrition and Pediatrics, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH.
J Acad Nutr Diet. 2021 Nov;121(11):2287-2300.e12. doi: 10.1016/j.jand.2020.11.002. Epub 2020 Dec 22.
Adequate protein intake by very-low-birth-weight preterm infants (≤1,500 g at birth) is essential to optimize growth and development. The estimated needs for this population are the highest of all humans, however, the recommended intake has varied greatly over the past several years. A literature search was conducted in PubMed, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane Central databases to identify randomized controlled trials evaluating the effect of prescribed protein intake and identified outcomes. Articles were screened by 2 reviewers, risk of bias was assessed, data were synthesized quantitatively and narratively, and each outcome was separately graded for certainty of evidence. The literature search retrieved 25,384 articles and 2 trials were included in final analysis. No trials were identified that evaluated effect of protein amount on morbidities or mortality. Moderate certainty evidence found a significant difference in weight gain when protein intake of greater than 3.5 g/kg/day from preterm infant formula was compared with lower intakes. Low-certainty evidence found no evidence of effect of protein intake of 2.6 vs 3.1 vs 3.8 g/kg/day on length, head circumference, skinfold measurements, or mid-arm circumference. Low-certainty evidence found some improvement in development measures when higher protein intake of 3.8 vs 3.1 vs 2.6 g/kg/day were compared. Low-certainty evidence found no significant difference in bone mineral content when these protein intakes were compared. No studies were identified that compared protein intake greater than 4.0 g/kg/day. This systematic review found that protein intake between 3.5 and 4.0 g/kg/day promotes weight gain and improved development.
极低出生体重早产儿（出生体重≤1500 克）的充足蛋白质摄入对于优化生长和发育至关重要。然而，与其他所有人群相比，该人群的估计需求量是最高的，但其推荐摄入量在过去几年中差异很大。在 PubMed、Embase、CINAHL（护理和联合健康文献累积索引）和 Cochrane 中央数据库中进行了文献检索，以确定评估规定蛋白质摄入量和确定结果的随机对照试验。由 2 名审查员筛选文章，评估偏倚风险，对数据进行定量和叙述性综合，并分别对每个结果进行证据确定性分级。文献检索检索到 25384 篇文章，最终分析纳入了 2 项试验。没有发现评估蛋白质量对发病率或死亡率影响的试验。中度确定性证据表明，与低摄入量相比，早产儿配方中蛋白质摄入量大于 3.5 g/kg/天时，体重增加有显著差异。低确定性证据表明，蛋白质摄入量为 2.6、3.1 和 3.8 g/kg/天时，对长度、头围、皮褶厚度或上臂中部周长没有影响。低确定性证据表明，当比较较高的蛋白质摄入量 3.8、3.1 和 2.6 g/kg/天时，发育测量有一些改善。低确定性证据表明，当比较这些蛋白质摄入量时，骨矿物质含量没有显著差异。没有发现比较蛋白质摄入量大于 4.0 g/kg/天的研究。本系统评价发现，蛋白质摄入量在 3.5 至 4.0 g/kg/天之间可促进体重增加和改善发育。
