Effectiveness of nutritional interventions to prevent nonprogressive congenital and perinatal brain injuries: a systematic review and meta-analysis of randomized trials.
Autor: | Curioni, Cintia C, Mocellin, Michel C, Tavares, Marina dos S, Silva, Ana C F da, Velasco, Patricia C de, Ribas, Simone A, Lamarca, Fernando, André, Charles |
---|---|
Předmět: |
CEREBRAL palsy prevention
THERAPEUTIC use of amino acids THERAPEUTIC use of vitamin A THERAPEUTIC use of vitamin D BRAIN abnormalities RELATIVE medical risk DOCOSAHEXAENOIC acid MAGNESIUM sulfate ACETYLCYSTEINE META-analysis MEDICAL information storage & retrieval systems CONFIDENCE intervals NUTRITIONAL assessment INTRAVENOUS therapy PREBIOTICS SYSTEMATIC reviews ORAL drug administration DEVELOPMENTAL disabilities HEALTH outcome assessment PREGNANT women DIET therapy RISK assessment NEURAL development LOW birth weight CHOLINE DESCRIPTIVE statistics BRAIN injuries MEDLINE ENTERAL feeding DATA analysis software FETAL alcohol syndrome NUTRITIONAL status CHILDREN |
Zdroj: | Nutrition Reviews; Nov2022, Vol. 80 Issue 11, p2136-2153, 18p |
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. [ABSTRACT FROM AUTHOR] |
Databáze: | Complementary Index |
Externí odkaz: |