Lin Luling, Gamble Greg D, Crowther Caroline A, Bloomfield Frank H, Agosti Massimo, Atkinson Stephanie A, Biasini Augusto, Embleton Nicholas D, Fewtrell Mary S, Lamy-Filho Fernando, Fusch Christoph, Gianni Maria L, Kanmaz Kutman H Gozde, Koo Winston, Litmanovitz Ita, Morgan Colin, Mukhopadhyay Kanya, Neri Erica, Picaud Jean-Charles, Rochow Niels, Roggero Paola, Singhal Atul, Stroemmen Kenneth, Tan Maw J, Tandoi Francesco M, Wood Claire L, Zachariassen Gitte, Harding Jane E
Liggins Institute, University of Auckland, Auckland 1023, New Zealand.
Neonatal Intensive Care Unit, Woman and Child Department, Ospedale Del Ponte, Insubria University, 21100 Varese, Italy.
Nutrients. 2022 Jan 18;14(3):418. doi: 10.3390/nu14030418.
Neonatal nutritional supplements are widely used to improve growth and development but may increase risk of later metabolic disease, and effects may differ by sex. We assessed effects of supplements on later development and metabolism. We searched databases and clinical trials registers up to April 2019. Participant-level data from randomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born preterm or small-for-gestational-age. Co-primary outcomes were cognitive impairment and metabolic risk. Supplementation did not alter cognitive impairment in toddlers (13 trials, = 1410; adjusted relative risk (aRR) 0.88 [95% CI 0.68, 1.13]; = 0.31) or older ages, nor alter metabolic risk beyond 3 years (5 trials, = 438; aRR 0.94 [0.76, 1.17]; = 0.59). However, supplementation reduced motor impairment in toddlers (13 trials, = 1406; aRR 0.76 [0.60, 0.97]; = 0.03), and improved motor scores overall (13 trials, = 1406; adjusted mean difference 1.57 [0.14, 2.99]; = 0.03) and in girls not boys ( = 0.03 for interaction). Supplementation lowered triglyceride concentrations but did not affect other metabolic outcomes (high-density and low-density lipoproteins, cholesterol, fasting glucose, blood pressure, body mass index). Macronutrient supplementation for infants born small may not alter later cognitive function or metabolic risk, but may improve early motor function, especially for girls.
新生儿营养补充剂被广泛用于促进生长发育，但可能会增加日后患代谢性疾病的风险，而且其影响可能因性别而异。我们评估了营养补充剂对后期发育和代谢的影响。我们检索了截至2019年4月的数据库和临床试验登记处。如果随机试验的目的是增加宏量营养素摄入量以促进早产儿或小于胎龄儿的生长或发育，则纳入参与者水平的数据。共同主要结局是认知障碍和代谢风险。补充剂并未改变幼儿期（13项试验，n = 1410；调整后相对风险[aRR] 0.88 [95%CI 0.68, 1.13]；P = 0.31）或更大年龄儿童的认知障碍，也未改变3岁以后的代谢风险（5项试验，n = 438；aRR 0.94 [0.76, 1.17]；P = 0.59）。然而，补充剂降低了幼儿期的运动障碍（13项试验，n = 1406；aRR 0.76 [0.60, 0.97]；P = 0.03），总体上改善了运动评分（13项试验，n = 1406；调整后平均差1.57 [0.14, 2.99]；P = 0.03），且在女孩中而非男孩中改善（交互作用P = 0.03）。补充剂降低了甘油三酯浓度，但未影响其他代谢结局（高密度和低密度脂蛋白、胆固醇、空腹血糖、血压、体重指数）。对小于胎龄儿进行宏量营养素补充可能不会改变后期认知功能或代谢风险，但可能改善早期运动功能，尤其是对女孩。
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