dc.contributor.advisor |
Jane Harding |
|
dc.contributor.author |
Lin, Luling |
|
dc.date.accessioned |
2021-03-18T22:56:57Z |
|
dc.date.available |
2021-03-18T22:56:57Z |
|
dc.date.issued |
2020 |
en |
dc.identifier.uri |
https://hdl.handle.net/2292/54742 |
|
dc.description.abstract |
Early nutritional supplementation for infants born preterm or small has been associated with improved early growth and cognitive outcomes, but may increase risk of later metabolic disease. Effects may also differ by sex. We assessed the effect of macronutrient supplements for preterm and small-for-gestational-age infants on developmental, metabolic and growth outcomes after hospital discharge.
Randomised trials were eligible if the intention was to increase macronutrient intake to improve growth or development of infants born preterm or small and post-discharge outcomes were assessed.
We undertook meta-analyses of aggregated data (AD) from published trials using random-effect models. We then undertook individual participant data meta-analysis (IPD-MA) using a one-stage procedure to model IPD from all trials simultaneously accounting for clustering within trials. We used mixed models to calculate overall effects adjusted for sex, gestational age and birthweight z-scores, and interactions with sex.
Data were analysed for 45 trials (4,710 infants) for AD and 21 trials (2,581 infants) for IPD. In the meta-analyses of AD, there were no significant differences between supplemented and unsupplemented groups for cognitive function in toddlers or children, but some metabolic risk markers were improved. Supplementation also decreased motor impairment, and increased weight and length/height in toddlers.
In the IPD-MA, there were no significant differences between supplemented and unsupplemented groups for cognitive function or metabolic risk in toddlers, childhood, adolescence or >3 years. Supplementation decreased the risk of motor impairment in toddlers overall, and in girls but not boys, improved motor scores in toddlers and increased growth in infancy. There were no other significant sex-specific effects. In subgroup analysis, supplemented SGA children had lower cognitive scores and some increased metabolic risk.
Early macronutrient supplements for infants born preterm or small does not alter cognitive function nor increase later metabolic risk. It may improve early motor function and increased growth in infancy, but the effects are small and the long-term effects are unclear. There was no evidence that supplements should be different for girls and boys. Further follow up of the children from the existing trials is needed to provide additional evidence about the long-term effects. |
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dc.publisher |
ResearchSpace@Auckland |
en |
dc.relation.ispartof |
PhD Thesis - University of Auckland |
en |
dc.relation.isreferencedby |
UoA99265338913902091 |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
http://creativecommons.org/licenses/by-nc-sa/3.0/nz/ |
|
dc.title |
Sex-Specific Nutrition after Preterm Birth |
|
dc.type |
Thesis |
en |
thesis.degree.grantor |
The University of Auckland |
en |
thesis.degree.level |
Doctoral |
en |
thesis.degree.name |
PhD |
en |
dc.date.updated |
2021-02-25T21:09:21Z |
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dc.rights.holder |
Copyright: The author |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |