Comparison 3. Alternative lipid emulsion (LE) versus soybean oil‐based lipid emulsion (S‐LE) (see Appendix 3).

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Days to regain birth weight	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
1.1 MS‐LE vs S‐LE	1	59	Mean Difference (IV, Fixed, 95% CI)	3.0 [‐0.73, 6.73]
1.2 OS‐LE vs S‐LE	3	223	Mean Difference (IV, Fixed, 95% CI)	‐0.19 [‐2.00, 1.62]
2 Growth rate (g/kg/day)	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
2.1 MS‐LE vs S‐LE	1	60	Mean Difference (IV, Fixed, 95% CI)	‐2.67 [‐8.20, 2.86]
2.2 OS‐LE vs S‐LE	2	123	Mean Difference (IV, Fixed, 95% CI)	‐0.42 [‐5.15, 4.30]
3 Parenteral nutrition‐associated liver disease (PNALD)/cholestasis (conjugated bilirubin ≥ 2 mg/dL)	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
3.1 OS‐LE vs S‐LE	2	159	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.15, 6.82]
3.2 MS‐LE vs S‐LE	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.13, 70.83]
4 PNALD/cholestasis (conjugated bilirubin ≥ 2 mg/dL): Combined subgroups	2	189	Risk Ratio (M‐H, Fixed, 95% CI)	1.14 [0.22, 5.84]
5 PNALD/cholestasis (any definition)	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
5.1 OS‐LE vs S‐LE	4	261	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.26, 3.86]
5.2 MS‐LE vs S‐LE	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.13, 70.83]
6 PNALD/cholestasis (any definition): Combined subgroups	4	291	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.31, 3.72]
6.1 OS‐LE vs S‐LE	4	291	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.31, 3.72]
7 Death before discharge	3		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
7.1 OS‐LE vs S‐LE	3	224	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.21, 4.82]
7.2 MS‐LE vs S‐LE	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Any retinopathy of prematurity	3		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
8.1 OS‐LE vs S‐LE	3	142	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.67, 1.43]
9 Any bronchopulmonary dysplasia	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
9.1 OS‐LE vs S‐LE	4	261	Risk Ratio (M‐H, Fixed, 95% CI)	0.69 [0.46, 1.04]
9.2 OS‐LE vs S‐LE (sensitivity analysis)	3	197	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.57, 1.79]
9.3 MS‐LE vs S‐LE	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.28, 3.63]
10 Chronic lung disease (oxygen requirement at 36 weeks)	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
10.1 OS‐LE vs S‐LE	2	123	Risk Ratio (M‐H, Fixed, 95% CI)	0.59 [0.34, 1.01]
10.2 MS‐LE vs S‐LE	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.28, 3.63]
11 Duration of ventilation (days)	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
11.1 OS‐LE vs S‐LE	3	202	Mean Difference (IV, Fixed, 95% CI)	‐0.20 [‐1.67, 1.26]
12 Duration of supplemental oxygen (days)	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
12.1 OS‐LE vs S‐LE	2	102	Mean Difference (IV, Fixed, 95% CI)	‐0.76 [‐16.99, 15.47]
13 Duration of hospital stay (days)	2	164	Mean Difference (IV, Fixed, 95% CI)	0.33 [‐7.44, 8.10]
13.1 OS‐LE vs S‐LE	2	164	Mean Difference (IV, Fixed, 95% CI)	0.33 [‐7.44, 8.10]
14 Need for home oxygen therapy	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
14.1 OS‐LE vs S‐LE	1	64	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Any sepsis (clinical or culture positive (or both))	5		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
15.1 MS‐LE vs S‐LE	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.67, 5.94]
15.2 OS‐LE vs S‐LE	5	301	Risk Ratio (M‐H, Fixed, 95% CI)	0.87 [0.56, 1.36]
16 Culture‐positive sepsis	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
16.1 OS‐LE vs S‐LE	2	164	Risk Ratio (M‐H, Fixed, 95% CI)	1.22 [0.54, 2.78]
17 Necrotising enterocolitis (≥ stage 2)	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
17.1 MS‐LE vs S‐LE	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	5.0 [0.25, 99.95]
17.2 OS‐LE vs S‐LE	1	59	Risk Ratio (M‐H, Fixed, 95% CI)	3.1 [0.13, 73.14]
18 Intraventricular haemorrhage (grade III‐IV)	2	104	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.10, 2.61]
18.1 OS‐LE vs S‐LE	2	104	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.10, 2.61]
19 Periventricular leukomalacia	1	64	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.01, 7.89]
19.1 OS‐LE vs S‐LE	1	64	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.01, 7.89]
20 Any patent ductus arteriosus	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
20.1 OS‐LE vs S‐LE	1	59	Risk Ratio (M‐H, Fixed, 95% CI)	1.03 [0.63, 1.71]
20.2 MS‐LE vs S‐LE	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.70, 1.82]
21 Air leaks	1	64	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 5.24]
21.1 OS‐LE vs S‐LE	1	64	Risk Ratio (M‐H, Fixed, 95% CI)	0.5 [0.05, 5.24]
22 Significant jaundice requiring treatment	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
22.1 OS‐LE vs S‐LE	2	109	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.52, 2.07]
23 Duration of phototherapy (days)	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
23.1 OS‐LE vs S‐LE	1	38	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐1.08, 0.88]
24 Hypertriglyceridaemia	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
24.1 OS‐LE vs S‐LE	3	142	Risk Ratio (M‐H, Fixed, 95% CI)	0.67 [0.12, 3.73]
24.2 MS‐LE vs S‐LE	1	12	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
25 Hyperglycaemia	1	64	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.22, 4.59]
25.1 OS‐LE vs S‐LE	1	64	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.22, 4.59]
26 Head growth velocity (cm/week)	1	100	Mean Difference (IV, Fixed, 95% CI)	‐0.08 [‐0.17, 0.01]
26.1 OS‐LE vs S‐LE	1	100	Mean Difference (IV, Fixed, 95% CI)	‐0.08 [‐0.17, 0.01]
27 Conjugated bilirubin levels (µmol/L)	5		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
27.1 MS‐LE vs S‐LE	1	60	Mean Difference (IV, Fixed, 95% CI)	‐1.03 [‐4.49, 2.43]
27.2 OS‐LE vs S‐LE	5	310	Mean Difference (IV, Fixed, 95% CI)	‐0.24 [‐1.03, 0.55]