肠道高剂量多可萨酸与极度早产婴儿的神经发育:系统性审查和元分析
Emily Shepherd1,2, Naho Ikeda1,3, Thomas R Sullivan1,4
1Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
Current developments in nutrition
|September 2, 2025
概括
在极度早产的婴儿中,高剂量的多可萨赫萨诺酸 (DHA) 补充剂并没有显著改善整体认知评分. 然而,直接乳液形式显示出潜在的益处,支持目前对神经发育支持的建议.
科学领域:
- 新生儿医学
- 神经科学
- 营养科学
背景情况:
- 极度早产的婴儿可能需要高剂量的DHA来实现最佳的神经发育和认知.
- 在这种人群中,高剂量DHA对神经发育的疗效的证据有限.
研究的目的:
- 在新生儿期内输入高剂量的DHA与在怀孕29周或之前出生的婴儿的神经发育结果之间的关联.
- 综合DHA补充和婴儿神经发育随机对照试验 (RCT) 的证据.
主要方法:
- 在多个数据库 (CINAHL,Cochrane Library,Embase,Medline,Scopus,Web of Science) 进行了系统的文献搜索,截至2024年4月11日.
- 符合条件的RCT涉及妊娠29周以下的婴儿,评估直接肠道DHA (≥40 mg/kg/d) 或强化母乳/配方 (≥0.60%的总脂肪酸).
- 使用元分析汇总数据,以全球认知分数为主要结果.
主要成果:
- 其中包括3项高质量的RCT,涉及2028名婴儿. 在经过校正的18-36个月或5-7岁的年龄段,元分析显示全球认知得分没有显著差异.
- 然而,使用直接肠道乳液的最大RCT在5年后显示认知得分有所改善 (MD3. 45;95%CI:0. 38,6. 52).
- 高剂量的DHA与轻度运动和认知障碍的减少有关,没有观察到不良反应.
结论:
- 在超早产的婴儿中,高剂量的DHA补充并没有通过元分析对整体认知得分产生显著影响.
- 一种直接的肠道乳液形式的DHA显示出改善认知结果的潜力.
- 这些发现支持目前对这种脆弱人群的DHA补充剂的建议.
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