高蛋白摄入量对早产儿后期结果的影响:系统性审查和元分析
Subhasish Das1,2, Thomas McClintock1, Barbara E Cormack1,3
1Liggins Institute, University of Auckland, Auckland, New Zealand.
Pediatric research
|June 10, 2024
概括
过早产生的婴儿高蛋白摄入量可能会损害新生儿的新陈代谢和后来的神经发育,短期增长益处有限. 对于这些脆弱的儿童,不建议摄入3.5g/kg/d或更多的蛋白质.
科学领域:
- 新生儿营养和发育儿科.
- 临床试验的元分析和证据综合.
背景情况:
- 足够的蛋白质对于早产婴儿的生长和神经发育至关重要.
- 高蛋白 (HP) 与低蛋白 (LP) 摄入对神经发育,生长和代谢结果的影响需要彻底评估.
研究的目的:
- 评估高蛋白 (HP) 与低蛋白 (LP) 摄入对早产婴儿神经发育,生长和生化异常的影响.
主要方法:
- 随机和准随机试验的系统审查和元分析,遵循PRISMA指南.
- 包括为早产婴儿 (<37周妊娠期) 提供蛋白质的研究,使用随机效应模型分析数据.
- 比较HP (≥3.5g/kg/d) 与LP (<3.5g/kg/d) 的摄入量.
主要成果:
- 高蛋白摄入量显示,在≥12个月后,没有神经障碍的生存率下降趋势 (低确定性证据).
- 摄入HP可能会增加婴儿认知障碍 (低确定性证据) 和生化异常 (如低度血和高血) 的风险.
- 惠普摄入的短期好处包括在出院或36周时更高的体重和头周长z-score,以及降低高血糖风险.
结论:
- 在早产婴儿中摄入高蛋白质可能会对新生儿代谢和神经发育结果产生负面影响.
- 惠普摄入的潜在危害超过了有限的短期增长优势.
- 由于潜在的风险,不建议早产婴儿摄入≥3.5g/kg/d的蛋白质.
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