Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small: An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: Growth

Neonatal nutritional supplements may improve early growth for infants born small, but effects on long-term growth are unclear and may differ by sex. We assessed the effects of early macronutrient supplements on later growth. We searched databases and clinical trials registers from inception to April...

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Main Authors: Luling Lin, Greg D. Gamble, Caroline A. Crowther, Frank H. Bloomfield, Massimo Agosti, Stephanie A. Atkinson, Augusto Biasini, Nicholas D. Embleton, Fernando Lamy Filho, Christoph Fusch, Maria L. Gianni, Hayriye Gözde Kanmaz Kutman, Winston Koo, Ita Litmanovitz, Colin Morgan, Kanya Mukhopadhyay, Erica Neri, Jean-Charles Picaud, Niels Rochow, Paola Roggero, Kenneth Stroemmen, Maw J. Tan, Francesco M. Tandoi, Claire L. Wood, Gitte Zachariassen, Jane E. Harding
Format: Article
Language:English
Published: MDPI AG 2022-01-01
Series:Nutrients
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Online Access:https://www.mdpi.com/2072-6643/14/2/392
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author Luling Lin
Greg D. Gamble
Caroline A. Crowther
Frank H. Bloomfield
Massimo Agosti
Stephanie A. Atkinson
Augusto Biasini
Nicholas D. Embleton
Fernando Lamy Filho
Christoph Fusch
Maria L. Gianni
Hayriye Gözde Kanmaz Kutman
Winston Koo
Ita Litmanovitz
Colin Morgan
Kanya Mukhopadhyay
Erica Neri
Jean-Charles Picaud
Niels Rochow
Paola Roggero
Kenneth Stroemmen
Maw J. Tan
Francesco M. Tandoi
Claire L. Wood
Gitte Zachariassen
Jane E. Harding
author_facet Luling Lin
Greg D. Gamble
Caroline A. Crowther
Frank H. Bloomfield
Massimo Agosti
Stephanie A. Atkinson
Augusto Biasini
Nicholas D. Embleton
Fernando Lamy Filho
Christoph Fusch
Maria L. Gianni
Hayriye Gözde Kanmaz Kutman
Winston Koo
Ita Litmanovitz
Colin Morgan
Kanya Mukhopadhyay
Erica Neri
Jean-Charles Picaud
Niels Rochow
Paola Roggero
Kenneth Stroemmen
Maw J. Tan
Francesco M. Tandoi
Claire L. Wood
Gitte Zachariassen
Jane E. Harding
author_sort Luling Lin
collection DOAJ
description Neonatal nutritional supplements may improve early growth for infants born small, but effects on long-term growth are unclear and may differ by sex. We assessed the effects of early macronutrient supplements on later growth. We searched databases and clinical trials registers from inception to April 2019. Participant-level data from randomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born preterm or small-for-gestational-age. Co-primary outcomes were cognitive impairment and metabolic risk. Supplementation did not alter BMI in childhood (kg/m<sup>2</sup>: adjusted mean difference (aMD) −0.11[95% CI −0.47, 0.25], <i>p</i> = 0.54; 3 trials, <i>n</i> = 333). Supplementation increased length (cm: aMD 0.37[0.01, 0.72], <i>p</i> = 0.04; 18 trials, <i>n</i> = 2008) and bone mineral content (g: aMD 10.22[0.52, 19.92], <i>p</i> = 0.04; 6 trials, <i>n</i> = 313) in infancy, but not at older ages. There were no differences between supplemented and unsupplemented groups for other outcomes. In subgroup analysis, supplementation increased the height z-score in male toddlers (aMD 0.20[0.02, 0.37], <i>p</i> = 0.03; 10 trials, <i>n</i> = 595) but not in females, and no significant sex interaction was observed (<i>p</i> = 0.21). Macronutrient supplementation for infants born small may not alter BMI in childhood. Supplementation increased growth in infancy, but these effects did not persist in later life. The effects did not differ between boys and girls.
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spelling doaj.art-5acf1e1bca024dd7a7b8050856fe9f5b2023-11-23T14:58:44ZengMDPI AGNutrients2072-66432022-01-0114239210.3390/nu14020392Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small: An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: GrowthLuling Lin0Greg D. Gamble1Caroline A. Crowther2Frank H. Bloomfield3Massimo Agosti4Stephanie A. Atkinson5Augusto Biasini6Nicholas D. Embleton7Fernando Lamy Filho8Christoph Fusch9Maria L. Gianni10Hayriye Gözde Kanmaz Kutman11Winston Koo12Ita Litmanovitz13Colin Morgan14Kanya Mukhopadhyay15Erica Neri16Jean-Charles Picaud17Niels Rochow18Paola Roggero19Kenneth Stroemmen20Maw J. Tan21Francesco M. Tandoi22Claire L. Wood23Gitte Zachariassen24Jane E. Harding25Liggins Institute, University of Auckland, Auckland 1023, New ZealandLiggins Institute, University of Auckland, Auckland 1023, New ZealandLiggins Institute, University of Auckland, Auckland 1023, New ZealandLiggins Institute, University of Auckland, Auckland 1023, New ZealandNICU, Woman and Child Department, Ospedale Del Ponte, Insubria University, 21100 Varese, ItalyDepartment of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, CanadaDonor Human Milk Bank Italian Association (AIBLUD), 20126 Milan, ItalyPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UKDepartamento de Medicina, Universidade Federal do Maranhão (UFMA), São Luís 65080-805, BrazilDepartment of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, CanadaFondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milan, ItalyDepartment of Neonatology, Bilkent City Hospital, Ankara 6800, TurkeyDepartment of Nutrition and Food Science, Wayne State University, Detroit, MI 48202, USADepartment of Neonatology, Meir Medical Center, Kfar Saba 4428164, IsraelDepartment of Neonatology, Liverpool Women’s Hospital, Liverpool L8 7SS, UKDepartment of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, IndiaDepartment of Psychology, University of Bologna, 40126 Bologna, ItalyDivision of Neonatology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, FranceDepartment of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, CanadaFondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milan, ItalyDepartment of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Rikshospitalet, Oslo University Hospital, 0188 Oslo, NorwayDepartment of Developmental Paediatrics, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UKNICU, Woman and Child Department, Ospedale Del Ponte, Insubria University, 21100 Varese, ItalyTranslational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UKH.C. Andersen Children’s Hospital, Odense University Hospital and University of Southern Denmark, 5000 Odense, DenmarkLiggins Institute, University of Auckland, Auckland 1023, New ZealandNeonatal nutritional supplements may improve early growth for infants born small, but effects on long-term growth are unclear and may differ by sex. We assessed the effects of early macronutrient supplements on later growth. We searched databases and clinical trials registers from inception to April 2019. Participant-level data from randomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born preterm or small-for-gestational-age. Co-primary outcomes were cognitive impairment and metabolic risk. Supplementation did not alter BMI in childhood (kg/m<sup>2</sup>: adjusted mean difference (aMD) −0.11[95% CI −0.47, 0.25], <i>p</i> = 0.54; 3 trials, <i>n</i> = 333). Supplementation increased length (cm: aMD 0.37[0.01, 0.72], <i>p</i> = 0.04; 18 trials, <i>n</i> = 2008) and bone mineral content (g: aMD 10.22[0.52, 19.92], <i>p</i> = 0.04; 6 trials, <i>n</i> = 313) in infancy, but not at older ages. There were no differences between supplemented and unsupplemented groups for other outcomes. In subgroup analysis, supplementation increased the height z-score in male toddlers (aMD 0.20[0.02, 0.37], <i>p</i> = 0.03; 10 trials, <i>n</i> = 595) but not in females, and no significant sex interaction was observed (<i>p</i> = 0.21). Macronutrient supplementation for infants born small may not alter BMI in childhood. Supplementation increased growth in infancy, but these effects did not persist in later life. The effects did not differ between boys and girls.https://www.mdpi.com/2072-6643/14/2/392macronutrient supplementationpreterm infantssmall-for-gestational-age infantsgrowthindividual participants data meta-analysissystematic review
spellingShingle Luling Lin
Greg D. Gamble
Caroline A. Crowther
Frank H. Bloomfield
Massimo Agosti
Stephanie A. Atkinson
Augusto Biasini
Nicholas D. Embleton
Fernando Lamy Filho
Christoph Fusch
Maria L. Gianni
Hayriye Gözde Kanmaz Kutman
Winston Koo
Ita Litmanovitz
Colin Morgan
Kanya Mukhopadhyay
Erica Neri
Jean-Charles Picaud
Niels Rochow
Paola Roggero
Kenneth Stroemmen
Maw J. Tan
Francesco M. Tandoi
Claire L. Wood
Gitte Zachariassen
Jane E. Harding
Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small: An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: Growth
Nutrients
macronutrient supplementation
preterm infants
small-for-gestational-age infants
growth
individual participants data meta-analysis
systematic review
title Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small: An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: Growth
title_full Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small: An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: Growth
title_fullStr Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small: An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: Growth
title_full_unstemmed Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small: An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: Growth
title_short Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small: An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: Growth
title_sort sex specific effects of nutritional supplements for infants born early or small an individual participant data meta analysis essence ipd ma ii growth
topic macronutrient supplementation
preterm infants
small-for-gestational-age infants
growth
individual participants data meta-analysis
systematic review
url https://www.mdpi.com/2072-6643/14/2/392
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