| LCPUFA supplemented formula compared with control formula for term infants for clinical outcomes (visual function, neurodevelopment and physical growth) |
|
Patient or population: term infants
Settings: hospital and community
Intervention: LCPUFA supplemented formula
Comparison: control formula |
| Outcomes |
Illustrative comparative risks* (95% CI) |
Relative effect
(95% CI) |
Number of participants
(studies) |
Quality of the evidence
(GRADE) |
Comments |
| Assumed risk |
Corresponding risk |
|
Control formula |
LCPUFA supplemented formula |
| Visual acuity/Teller cards at 12 months (cycles/degree) ‐ DHA and AA vs normal term formula |
Mean visual acuity (cycles/degree) ranged across control groups from 3.31 to 10 |
Mean visual acuity (cycles/degree) ranged across intervention groups from 3.28 to 9.77 |
MD ‐0.01 (95% CI ‐0.12 to 0.11) |
256
(3 studies) |
⊕⊕⊝⊝
low
|
Downgraded 2 levels
Reasons: small sample size, high rate of attrition |
| Sweep VEP acuity at 12 months (LogMAR) ‐ DHA and AA vs normal term formula |
Mean sweep VEP acuity (LogMAR) ranged across control groups from 0.31 to 0.339 |
Mean sweep VEP acuity (LogMAR) ranged across intervention groups from 0.14 to 0.2 |
MD ‐0.15 (95% CI ‐0.17 to ‐0.13) |
244
(3 studies) |
⊕⊕⊝⊝
low
|
Downgraded 2 levels
Reasons: small sample size, high rate of attrition in 2 RCTs |
| MDI scores (Bayley) at 18 months ‐ DHA and AA vs normal term formula |
Mean MDI ranged across control groups from 98.3 to 105.4 |
Mean MDI ranged across intervention groups from 94.5 to 105.6 |
MD 0.06 (95% CI ‐ 2.01 to 2.14) |
661
(4 studies) |
⊕⊕⊝⊝
low
|
Downgraded 2 levels
Reasons: small sample size, high rate of attrition in 2 RCTs, high statistical heterogeneity
(I² = 75%) |
| PDI scores (Bayley) at 18 months ‐ DHA and AA vs normal term formula |
Mean PDI ranged across control groups from 96.4 to 102 |
Mean PDI ranged across intervention groups from 95.9 to 105.8 |
MD 0.69 (95% CI ‐0.78 to 2.16) |
661
(4 studies) |
⊕⊕⊝⊝
low
|
Downgraded 2 levels
Reasons: small sample size, high rate of attrition in 2 RCTs, high statistical heterogeneity
(I² = 61%) |
| Weight at 12 months (z scores) ‐ DHA and AA vs normal term formula |
Mean z scores for weight ranged across control groups from ‐0.21 to 0.35 |
Mean z scores for weight ranged across intervention groups from ‐0.9 to 0.4 |
MD ‐0.23 (95% CI ‐0.40 to ‐0.06) |
521
(5 studies) |
⊕⊕⊝⊝
low
|
Downgraded 2 levels
Reasons: small sample size, high rate of attrition in 3 RCTs, unclear allocation concealment in 2 RCTs, high statistical heterogeneity
(I² = 83%) |
| Length at 12 months (z scores) ‐ DHA and AA vs normal term formula |
Mean z scores for length ranged across control groups from ‐0.11 to 0.34 |
Mean z scores for length ranged across control groups from ‐0.04 to 0.16 |
MD ‐0.04 (95% CI ‐0.19 to 0.11) |
521
(5 studies) |
⊕⊕⊝⊝
low
|
Downgraded 2 levels
Reasons: small sample size, high rate of attrition in 3 RCTs, unclear allocation concealment in 2 RCTs |
| Head circumference at 12 months (z scores) ‐ DHA and AA vs normal term formula |
Mean z scores for head circumference ranged across control groups from 0.18 to 0.94 |
Mean z scores for head circumference ranged across control groups from 0.01 to 0.93 |
MD ‐0.13 (95% CI ‐0.32 to 0.05) |
464
(4 studies) |
⊕⊕⊝⊝
low
|
Downgraded 2 levels
Reasons: small sample size, high rate of attrition in 3 RCTs |
| *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
CI: confidence interval; MD, mean difference |
| GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate
Very low quality: We are very uncertain about the estimate |
