Summary of findings 5. All fish oil containing LE versus S‐LE for parenterally fed preterm infants.
| All fish oil containing LE versus S‐LE for parenterally fed preterm infants(comparison 8) | ||||||
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Population: Parenterally fed preterm infants
Intervention: All fish oil containing 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 (control) | All fish oil containing LE | |||||
| Death before discharge Follow‐up: birth until discharge | Study population | RR 1.28 (0.69 to 2.35) | 399 (5 studies) | ⊕⊕⊝⊝ low1,2,3 | Downgraded 2 levels for imprecision | |
| 86 per 1000 | 110 per 1000 (59 to 202) | |||||
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Days to regain birth weight Follow‐up: birth until discharge |
The mean days to regain birth weight in the control groups was 9.6 days |
The mean days to regain birth weight in the intervention groups was 0.81 days higher (0.43 lower to 2.05 higher) | 261 (3 studies) | ⊕⊕⊝⊝ low2,4,5 | 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 0.69 g/kg/day higher (0.19 lower to 1.57 higher) |
374 (5 studies) |
⊕⊝⊝⊝ very low,2,4,5,6 | Downgraded 2 levels for imprecision and 1 level for possible bias: very heterogenous outcome with growth rate reported for different time periods by different studies and Imputed values used |
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Bronchopulmonary dysplasia/chronic lung disease Follow‐up: birth until discharge |
Study population | RR 1.02 (0.7 to 1.5) | 341 (4 studies) | ⊕⊕⊝⊝ low2,3,5 | Downgraded 2 levels for imprecision | |
| 245 per 1000 | 250 per 1000 (172 to 368) | |||||
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Any sepsis (clinical and/or culture positive) Follow‐up: birth until discharge |
Study population | RR 0.92 (0.61 to 1.39) | 373 (5 studies) | ⊕⊕⊝⊝ low2,3,5 | Downgraded 2 levels for imprecision | |
| 198 per 1000 | 182 per 1000 (121 to 275) | |||||
| Retinopathy of prematurity (≥ stage 3) Follow‐up: birth until discharge | Study population | RR 0.43 (0.06 to 2.85) | 256 (3 studies) | ⊕⊕⊝⊝ low2,3 | 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 0.8 (0.29 to 2.16) | 341 (4 studies) | ⊕⊕⊝⊝ low2,3,5 | Downgraded 2 levels for imprecision | |
| 50 per 1000 | 40 per 1000 (15 to 109) | |||||
| 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). 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 Two studies did not report on death before discharge, however we did not downgrade for bias as most studies reported on this outcome. 2 Optimal information size not achieved. 3 Confidence intervals cross 0.75 or 1.25. 4 Wide confidence intervals crossing appreciable harm and benefit. 5 Not enough studies to make a reliable funnel plot.
6 Bias due to different studies reporting growth rate for different time periods.