Effectiveness of nutritional interventions to prevent nonprogressive congenital and perinatal brain injuries: a systematic review and meta-analysis of randomized trials.

Autor:	Curioni CC; Department of Nutrition in Public Health, State University of Rio de Janeiro, Rio de Janeiro, Brazil., Mocellin MC; Department of Fundamental Nutrition-Nutrition School, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil., Tavares MDS; Nutrition Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil., da Silva ACF; Department of Nutrition in Public Health, State University of Rio de Janeiro, Rio de Janeiro, Brazil., de Velasco PC; Department of Applied Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil., Ribas SA; Department of Public Health Nutrition-Nutrition School, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil., Lamarca F; Department of Applied Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil., André C; Department of Neurology-Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro Brazil.
Jazyk:	angličtina
Zdroj:	Nutrition reviews [Nutr Rev] 2022 Oct 10; Vol. 80 (11), pp. 2136-2153.
DOI:	10.1093/nutrit/nuac028
Abstrakt:	Context: Nutritional interventions for newborns with brain injury are scarce, and there are gaps in the knowledge of their mechanisms of action in preventing the occurrence of cerebral palsy (CP) or the incidence of other developmental disabilities. Objective: The objective of this review was to assess the effect of nutritional interventions in preventing nonprogressive congenital or perinatal brain injuries, or in improving outcomes related to neurological development. Data Sources: Randomized trials on any nutritional intervention for pregnant women at risk of preterm delivery, or for children with low birth weight, preterm, or with confirmed or suspected microcephaly, CP, or fetal alcohol syndrome disorders (FASDs) were retrieved from MEDLINE, Embase, Scopus, Web of Science, LILACS, and CENTRAL databases from inception to September 17, 2020. Data Extraction: Data extraction, risk of bias (Cochrane Risk of Bias tool 2), and quality of evidence (GRADE approach) were assessed by 2 authors. Data Analysis: Pooled risk ratios (RRs) with 95% confidence intervals were calculated using a random-effects meta-analysis. Seventeen studies were included on intravenous interventions (magnesium sulfate [n = 5], amino acids [n = 4], vitamin A [n = 1], and N-acetylcysteine [n = 1]); enteral interventions (vitamin D [n = 1], prebiotic [n = 1], nutrient-enriched formula [n = 1], and speed of increasing milk feeds [n = 1]); and oral interventions (choline [n = 1] and docosahexaenoic acid, choline, and uridine monophosphate [n = 1]). All studies assessed CP, except 1 on FASDs. Eight studies were judged as having high risk of bias. Five studies (7413 babies) with high-quality evidence demonstrated decreased risk of childhood CP (RR = 0.68, 95% CI: 0.52-0.88) with magnesium sulfate. Interventions with amino acids had no effect on CP prevention or other outcomes. Except for 1 study, no other intervention decreased the risk of CP or FASDs. Conclusion: Although different types of nutritional interventions were found, only those with antenatal magnesium sulfate were effective in decreasing CP risk in preterm infants. Well-designed, adequately powered randomized clinical trials are required. (© The Author(s) 2022. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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