Summary of findings 1. Fat supplementation compared to control for promoting growth in preterm infants.
| Fat supplementation compared to control for promoting growth in preterm infants | ||||||
| Patient or population: preterm infants Setting: two neonatal units in Sweden Intervention: fat supplementation of human milk Comparison: unsupplemented human milk | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with control | Risk with Fat supplementation | |||||
| Growth ‐ weight ‐ weight gain (g/kg/day) | The mean weight gain in the unsupplemented human milk group was 15.3 g/kg/day. | MD 0.6 g/kg/day higher (2.4 lower to 3.6 higher) | ‐ | 14 (1 RCT) | ⊕⊝⊝⊝ Very low 1 2 | |
| Growth ‐ length ‐ length gain (cm/week) | The mean length gain in the unsupplemented human milk group was 0.8 cm/week. | MD 0.1 cm/week higher (0.08 lower to 0.3 higher) | ‐ | 14 (1 RCT) | ⊕⊝⊝⊝ Very low 1 2 | |
| Growth ‐ head circumference ‐ head growth (cm/week) | The mean head growth in the unsupplemented human milk group was 0.9 cm/week. | MD 0.2 cm/week higher (0.07 lower to 0.4 higher) | ‐ | 14 (1 RCT) | ⊕⊝⊝⊝ Very low 1 2 | |
| Neurodevelopmental outcomes | ‐ | ‐ | ‐ | ‐ | ‐ | None of the included studies reported on neurodevelopmental outcomes. |
| Duration of hospital admission (days) | ‐ | ‐ | ‐ | ‐ | ‐ | None of the included studies reported on duration of hospital admission. |
| Feeding intolerance | 0 per 1000 | 0 per 1000 (0 to 0) | RR 3.00 (0.1 to 64.3) | 16 (1 RCT) | ⊕⊝⊝⊝ Very low 1 3 | . |
| Necrotising enterocolitis | ‐ | ‐ | ‐ | ‐ | ‐ | None of the included studies reported on necrotising enterocolitis. |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio; OR: odds ratio; | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: we are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 Downgraded one level for risk of bias: most of the trials lacked methodological details
2 Downgraded one level for imprecision: few participants, wide confidence intervals, which include meaningful benefit and harm
3 Downgraded two levelsfor serious imprecision: few participants, few events, wide confidence intervals, which include meaningful benefit and harm