Early high dose versus low dose parenteral amino acids administration in the preterm infants: A meta-analysis

Abstract

Objective: Preterm infants may face difficulty on getting the nutrition required for growth due to incompetence of sucking and immaturity of the gastrointestinal. Preterm infants require higher amounts of amino acids and protein to support the growth of lean body mass and tissue. Administrating amino acid supplementation during the first hour of life is the key to preventing early neonatal malnutrition and can be beneficial in the growth of the neonates. Objectives: Aim of this study is to determine the effects of early high dose parenteral amino acids administration versus low dose in preterm infants from all collected studies. Methods: This is a meta-analysis study that studies were collected MedLine, PubMed, and Cochrane Central Register of Controlled Trials comparing early high dose parenteral amino acids versus low dose. High-quality studies, as assessed by Jadad Criteria, were used to evaluate outcomes such as anthropometric data, length of hospital stays, and morbidities. Results: A total of 9 Randomized controlled trials (RCTs) with total of 960 participants were included in the analysis. Analysis of these studies showed a statistically significant reduction in the time to regain birth weight in the group of early high-dose amino acids administration in the preterm infants. Reductions were 0.79 day (MD 0.79 day, 95% CI 0.06 to 1.52 day; participants = 655; studies = 6; I2 = 0%) (P= 0.03). It also showed a statistically significant reduction in the length of stay with a reduction of 2.09 days in the early high-dose parenteral amino acids groups (MD 2.09 days, 95% CI 1.01 to 3.17 day; participants = 500; studies = 5; I2 = 0%) (P= 0.0002). No significant difference in morbidity of each group was found. Conclusion: Administration of early high-dose amino acids reduced the time to regain birth weight and the length of hospitalization in preterm infants. The analysis did not show any significant increase in the risk of morbidity.