Summary of findings 1. MOFS‐LE versus S‐LE for parenterally fed preterm infants.
| MOFS‐LE versus S‐LE for parenterally fed preterm infants(comparison 1) | ||||||
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Population: Parenterally fed preterm infants
Intervention: MOFS‐LE Comparison: S‐LE | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| S‐LE (control) | MOFS‐LE | |||||
| Death before discharge | Study population | RR 1.26 (0.68 to 2.31) | 369 (5 studies) |
⊕⊕⊝⊝ low | Downgraded 2 levels for imprecision | |
| 86 per 1000 | 108 per 1000 (58 to 199) | |||||
| Days to regain birth weight Follow‐up: birth until discharge | The mean days to regain birth weight in the control groups was 9.6 days1 | The mean days to regain birth weight in the intervention groups was 1.12 days higher (0.17 lower to 2.41 higher) | 234 (3 studies) | ⊕⊕⊝⊝ low2,3,4 | Not downgraded for inconsistency but downgraded 2 levels for imprecision | |
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Rate of weight gain (g/kg/day) Follow‐up: reported for variable time periods in different studies |
The mean rate of weight gain (g/kg/day) ranged across control groups from 5.42 g/kg/day to 24.5 g/kg/day | The mean rate of weight gain (g/kg/day) in the intervention groups was 0.71 g/kg/day higher (0.17 lower to 1.6 higher) | 347 (5 studies) |
⊕⊝⊝⊝ very low,2,3,4 | Downgraded 2 levels for imprecision and 1 level for possible bias: as very heterogenous outcome with growth rate reported for different time periods by different studies and Imputed values were used | |
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Bronchopulmonary dysplasia/chronic lung disease Follow‐up: birth until discharge |
Study population | RR 1.02 (0.7 to 1.49) | 314 (4 studies) | ⊕⊕⊝⊝ low2,5 | Downgraded 2 levels for imprecision | |
| 245 per 1000 | 250 per 1000 (172 to 365) | |||||
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Any sepsis (clinical and/or culture positive) Follow‐up: birth until discharge |
Study population | RR 0.94 (0.62 to 1.42) | 346 (5 studies) |
⊕⊕⊝⊝ low2,4,5 | Downgraded 2 levels for imprecision | |
| 198 per 1000 | 186 per 1000 (123 to 281) | |||||
| Retinopathy of prematurity (≥ stage 3) Follow‐up: birth until discharge | Study population | RR 0.43 (0.06 to 2.85) | 256 (3 studies) | ⊕⊕⊝⊝ low2,5,6,7 | Downgraded 2 levels for imprecision | |
| 23 per 1000 | 10 per 1000 (1 to 66) | |||||
| Parenteral nutrition‐associated liver disease/cholestasis Follow‐up: birth until discharge | Study population | RR 0.78 (0.29 to 2.13) | 314 (4 studies) | ⊕⊕⊝⊝ low2,5,8 | Downgraded 2 levels for imprecision | |
| 50 per 1000 | 39 per 1000 (15 to 107) | |||||
| *The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). MOFS‐LE: medium chain triglycerides‐olive‐fish‐soy lipid emulsion; S‐LE: soy lipid emulsion; CI: confidence interval; RR: risk ratio | ||||||
| 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. | ||||||
1 Mean days to regain birth weight in the control group (calculated value). 2 Optimal information size not achieved. 3 Wide confidence intervals crossing appreciable harm or benefit. 4 Too few studies to make a reliable funnel plot. 5 Confidence intervals cross 0.75 or 1.25. 6 Possibility of outcome reporting bias as some studies did not provide data on ROP. 7 How blinding was achieved is not described in one study. 8 Objective outcome: less likely to be affected by problems in blinding.