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Prospective cohort studies using hydrolysed formulas for allergy prevention in atopy-prone newborns: a systematic
A Schoetzau1, U Gehring, H E Wichmann
1GSF--National Research Centre for Environment and Health, Institute of Epidemiology, Neuherberg, Germany. schoetzau@gsf.de
Insights
Partially hydrolyzed infant formulas show a tendency towards allergy protection. More research is needed to compare hydrolyzed formulas with standard ones for allergy prevention.
Area of Science:
- Allergy and immunology
- Pediatrics
- Nutritional science
Background:
- Infant formulas are a common alternative to breastfeeding.
- Hydrolyzed infant formulas are designed to reduce allergenicity.
- The allergy preventive effects of these formulas require systematic evaluation.
Purpose of the Study:
- To systematically review publications on the allergy preventive effects of extensively and partially hydrolyzed infant formulas.
- To assess the methodological quality of included studies.
- To synthesize findings on the efficacy of hydrolyzed formulas in preventing allergies.
Main Methods:
- Systematic literature search using multiple strategies.
- Inclusion criteria: prospective cohort studies, randomization, family history of atopy, and at least one-year follow-up.
- Methodological quality assessment using a bias reduction instrument (0-7 points).
Main Results:
- Ten out of 16 identified studies met the inclusion criteria.
- Significant heterogeneity observed in study designs, interventions, and outcome definitions.
- Studies on partial hydrolysates indicated a trend towards allergy protection.
- Results for extensive hydrolysates were not comparable due to design differences.
Conclusions:
- Partially hydrolyzed formulas demonstrated a consistent trend towards allergy protection.
- Extensive hydrolysates' effects could not be reliably compared due to study heterogeneity.
- Further well-designed studies with sufficient statistical power are necessary to compare hydrolyzed formulas against standard formulas for allergy prevention.
Unlabelled:
The aim of this study is to give a systematic overview on publications having investigated the allergy preventive effect of extensively and/or partially hydrolysed infant formulas. Publications were searched by several strategies. Inclusion criteria were: prospective cohort study, randomisation, family history of atopy of the subjects, follow-up for at least the 1st year of life. Studies were described systematically as to methods, study participants, interventions and co-interventions, and study outcomes. The methodological quality was judged according to an instrument assessing the reduction of bias (score between 0 and 7 points). Data of studies having examined partial hydrolysates are presented as odds ratios. Of 16 studies found, 10 fulfilled the inclusion criteria. Study designs showed considerable differences as to methods, intervention and co-intervention procedures and definition of outcomes. Methodological quality varied between 0 and 6 points. The comparison of exclusively test- and control formula-fed groups showed a uniform tendency towards allergy protection in studies with partial hydrolysates. Study results on the effect of extensive hydrolysates were not comparable because of major differences in study designs.
Conclusion:
More well-designed studies with an adequate statistical power are needed to compare the allergy preventive effect of partially and extensively hydrolysed formulas with a standard infant formula.