Summary of findings 3. OS‐LE versus S‐LE for parenterally fed preterm infants.

OS‐LE versus S‐LE for parenterally fed preterm infants(comparison 3)
Population: Parenterally fed preterm infants Intervention: OS‐LE Comparison: S‐LE
Outcomes	Illustrative comparative risks* (95% CI)		Relative effect (95% CI)	Number of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	S‐LE	OS‐LE
Death before discharge (incidence) Follow‐up: birth until discharge	Study population		RR 1 (0.21 to 4.82)	224 (3 studies)	⊕⊕⊝⊝ low1,2,3,4	Downgraded 2 levels for imprecision
	27 per 1000	27 per 1000 (6 to 129)
Days to regain birth weight (days) Follow‐up: birth until discharge	The mean days to regain birth weight in the control groups was 11.69 days	The mean days to regain birth weight in the intervention groups was 0.19 days lower (2 lower to 1.62 higher)		223 (3 studies)	⊕⊕⊝⊝ low1,2,4,5	Downgraded 2 levels for imprecision
Rate of weight gain (g/kg/day) Follow‐up: variable	The mean rate of weight gain (g/kg/day) ranged across control groups from 5.67 to 17.8 g/kg/day	The mean rate of weight gain (g/kg/day) in the intervention groups was 0.42 g/kg/day lower (5.15 lower to 4.3 higher)		123 (2 studies)	⊕⊕⊝⊝ low1,2,4,5	Duration for which the data were presented was variable in different studies; imputed values were used Downgraded 2 levels for imprecision.
Bronchopulmonary dysplasia/chronic lung disease (incidence ‐ variable definition) Follow‐up: birth until discharge	Study population		RR 0.69 (0.46 to 1.04)	261 (4 studies)	⊕⊝⊝⊝ very low1,2,3,4,6	Downgraded 2 levels for imprecision and 1 level for heterogeneity in risk difference Unexplained large difference in duration of ventilation in one study.
	265 per 1000	183 per 1000 (195 to 444)
Bronchopulmonary dysplasia/chronic lung disease (sensitivity analysis) Follow‐up: birth until discharge	Study population		RR 1.01 (0.57 to 1.79)	197 (3 studies)	⊕⊕⊝⊝ low1,2,3,4	Downgraded 2 levels for imprecision No heterogeneity in sensitivity analysis
	150 per 1000	152 per 1000 (171 to 543)
Duration of ventilation (days) Follow‐up: birth until discharge	The mean duration of ventilation (days) in the control groups was 16.4 days	The mean duration of ventilation (days) in the intervention groups was 0.2 days lower (1.67 lower to 1.26 higher)		202 (3 studies)	⊕⊝⊝⊝ very low6	Downgraded 2 levels for imprecision and 1 level for heterogeneity Imputed values used for 1 study
Any sepsis (clinical and/or culture positive) Follow‐up: birth until discharge	Study population		RR 0.87 (0.56 to 1.36)	301 (5 studies)	⊕⊝⊝⊝ very low2,3,4,7	Downgraded 2 levels for imprecision and 1 level for risk of bias
	217 per 1000	189 per 1000 (122 to 295)
*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). OS‐LE: olive‐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 Objective outcome unlikely to be affected by blinding.
² Optimal information size not achieved.
³ Confidence intervals cross 0.75 and 1.25.
⁴ Too few studies to make a funnel plot.
⁵ Wide confidence intervals crossing appreciable harm and benefit.
⁶ Heterogeneity > 40% and opposite direction of point estimates.
⁷ One study was not blinded; method of blinding was not described in two studies.