Effects of Early and Late Parenteral Nutrition on Clinical Outcomes in Very Low Birth Weight Preterm Infants: A Systematic Review and Meta-analysis

Background: Parenteral Nutrition (PN) provided to the Very Low Birth Weighti¼ˆVLBWi¼‰premature infants should be resulted in gradually development as of the other fetuses following the same gestational age. Even after providing the proven beneficial parenteral nutrition supplements, VLBW infants are often presents with the unfavorable results; the main reason behind it is the decision of the administration of parenteral nutrition, whether it is in early life or later days. Objective: The objective of this study is to explore the effect of early and late parenteral nutrition in the VLBW premature infants. In this study we hypothesize that early parenteral nutrition is associated with comparatively beneficial outcomes. Methods: The PubMed (PubMed Central), Medline, and Google Scholar databases were searched from 1993 to 2013. Methodological quality assessment was based on the PRISMA guidelines. Data analysis were conducted with RevMan 5.3 Results: Ten studies including thirteen trials met our inclusion criteria. The aggregate results of trials showed that early parenteral nutrition was well tolerated by VLBW preterm infants and there was significant reduction in sepsis (RR=0.82, 95% CI=0.69~0.98, P=0.03) Conclusion: Comparison made between the patients provided early and late parenteral nutrition, the development and reduction of clinical disease were significantly lower in the early parenteral nutrition group. The cost-effectiveness of these preparations, however, needs to be further explored. The poor qualities of studies call into a question and robustness of the analysis.