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Fish oil- and soy oil-based lipid emulsions in neonatal parenteral nutrition: a systematic review and meta-analysis

European Journal of Clinical Nutrition volume 70, pages 1106–1115 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

The precise role of fish oil-based lipid emulsions (FBL=any lipid emulsion containing any amount of fish oil) and soy oil-based lipid emulsions (SBL=any lipid emulsion not containing fish oil or containing at least 50% soy oil) in neonatal parenteral nutrition (PN) needs to be explored.

Subjects/Methods:

The PubMed, MedLine and Google Scholar databases were searched for randomised control trials in which PN with FBL and SBL was the only difference between intervention and control groups. Methodological quality was assessed based on the Cochrane handbook for systemic reviews and Jadad’s score. Revman 5.2 software was used for meta-analysis.

Results:

Of 420 trials, 25 met the inclusion criteria. The aggregate results showed that both FBLs and SBLs are beneficial. FBLs were associated with significantly lower incidences of cholestasis (relative risk (RR)=0.50; 95% confidence interval (CI)=0.27–0.92, P=0.03) compared with SBLs. FBLs also had a tendency to improve the rates of weight gain, increase in head circumference and the time to regain birth weight (mean difference (MD)=0.24; 95% CI=−0.63–0.15). SBLs were associated with reduced duration of respiratory support (MD=2.22, 95% CI=0.35–4.09, P=0.02) and mortality rate in the first 28 days (RR=1.24, 95% CI=–0.72–2.13).

Conclusions:

Both FBLs and SBLs are beneficial for neonatal PN. FBLs reduce cholestasis, and SBLs reduce the duration of respiratory support.

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Acknowledgements

This research was supported by grants from the Suzhou Science and Technology Development Project (No. SYS201136, SYS201440), the Natural Science Foundation Project of Jiangsu Province (No. BK20141183), the Research Project of Department of Health of Jiangsu Province (No. H201316), the 135 Project of Department of Health of Jiangsu Province (No. RC2007076) and a research project of the Suzhou Key Laboratory of Children's Developmental Brain Injury Prevention and Care (No. SZS201108). We acknowledge all members of the laboratory for sharing reagents and advice.

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  1. P Kotiya and X Zhao: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Neonatology, Children’s Hospital of Soochow University, Suzhou, China

    P Kotiya, X Zhao, P Cheng, X Zhu & Z Xiao

  2. Department of Neonatology Surgery, Children’s Hospital of Soochow University, Suzhou, China

    J Wang

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Correspondence to X Zhu.

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Kotiya, P., Zhao, X., Cheng, P. et al. Fish oil- and soy oil-based lipid emulsions in neonatal parenteral nutrition: a systematic review and meta-analysis. Eur J Clin Nutr 70, 1106–1115 (2016). https://doi.org/10.1038/ejcn.2016.69

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