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New-generation intravenous fat emulsions and bronchopulmonary dysplasia in preterm infants: a systematic review and meta-analysis

Journal of Perinatology volume 40, pages 1585–1596 (2020)Cite this article

Subjects

Abstract

Background

Fat emulsion is an important component of parenteral nutrition in premature infants. However, intravenous fat emulsions (IVFE) was reported to be associated with some serious complications, such as bronchopulmonary dysplasia (BPD). Compared to conventional soybean oil-based IVFE, new-generation IVFE may protect against BPD but the results are conflicting.

Methods

Relevant literatures search was conducted and the summary effect estimates of odds ratio (OR) and 95% confidence interval (CI) were calculated with fixed-effects models.

Results

Of 22 studies involving 3781 infants were selected in this study and BPD was reported as part of the included studies. The pooled estimate for 13 studies, comparing administration of new-generation IVFE with conventional IVFE, indicated that new-generation IVFE was not associated with a reduced risk of BPD in preterm infants, compared with conventional IVFE (OR 0.96; 95% CI 0.80–1.14); the pooled estimate for 18 studies, comparing administration of fish oil-containing IVFE with non-fish oil IVFE, indicated that fish oil-containing IVFE has no protective effect against the occurrence of BPD in preterm infants (OR 0.88; 95% CI 0.71–1.08).

Conclusions

There is no evidence to support that the new-generation IVFEs could prevent the incidence of BPD or fish oil-containing IVFEs could show a beneficial effect to BPD in premature infants.

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Fig. 1: Study selection flowchart.
Fig. 2: Methodological quality evaluation according to Cochrane Risk of Bias Tool of the included RCT studies.
Fig. 3: Forest plot of the pooled analyses of administrating new-generation IVFEs compared with soybean oil-based IVFE (SOFE) and the incidence of BPD.
Fig. 4: Forest plot of the pooled analyses of administrating fish oil-contained IVFEs (FOFE) compared with non-fish oil contained IVFEs (non-FOFE) and the incidence of BPD.

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Funding

This work was supported by the National Science Foundation of China (Nos. 81630038, 81771634, 81300524, 81330016, and 81842011); National Key R& D Program of China (2017YFA0104200); Grant from Ministry of Education of China (IRT0935); Grant from Science and Technology Bureau of Sichuan Province (2016TD0002); Grant of clinical discipline program (Neonatology) from the Ministry of Health of China (1311200003303).

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  1. These authors contributed equally: Xue Fan, Ying Tang

Authors and Affiliations

  1. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Xue Fan, Jun Tang, Juan Chen, Jing Shi, Hua Wang, Bin Xia, Yi Qu & Dezhi Mu

  2. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China

    Xue Fan, Ying Tang, Jun Tang, Juan Chen, Jing Shi, Hua Wang, Bin Xia, Yi Qu & Dezhi Mu

  3. Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Ying Tang

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XF and YT contributed equally to this report, XF and YT designed the study and wrote the manuscript. JT, JC and JS performed the literature searches. HW and BX collected the data. YQ conducted the statistical analysis. DM revised the manuscript and final approval of the version to be published.

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Fan, X., Tang, Y., Tang, J. et al. New-generation intravenous fat emulsions and bronchopulmonary dysplasia in preterm infants: a systematic review and meta-analysis. J Perinatol 40, 1585–1596 (2020). https://doi.org/10.1038/s41372-020-0716-z

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