Abstract
Adequate protein intake by very-low-birth-weight preterm infants (≤1,500 g at birth)
is essential to optimize growth and development. The estimated needs for this population
are the highest of all humans, however, the recommended intake has varied greatly
over the past several years. A literature search was conducted in PubMed, Embase,
CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane Central
databases to identify randomized controlled trials evaluating the effect of prescribed
protein intake and identified outcomes. Articles were screened by 2 reviewers, risk
of bias was assessed, data were synthesized quantitatively and narratively, and each
outcome was separately graded for certainty of evidence. The literature search retrieved
25,384 articles and 2 trials were included in final analysis. No trials were identified
that evaluated effect of protein amount on morbidities or mortality. Moderate certainty
evidence found a significant difference in weight gain when protein intake of greater
than 3.5 g/kg/day from preterm infant formula was compared with lower intakes. Low-certainty
evidence found no evidence of effect of protein intake of 2.6 vs 3.1 vs 3.8 g/kg/day
on length, head circumference, skinfold measurements, or mid-arm circumference. Low-certainty
evidence found some improvement in development measures when higher protein intake
of 3.8 vs 3.1 vs 2.6 g/kg/day were compared. Low-certainty evidence found no significant
difference in bone mineral content when these protein intakes were compared. No studies
were identified that compared protein intake greater than 4.0 g/kg/day. This systematic
review found that protein intake between 3.5 and 4.0 g/kg/day promotes weight gain
and improved development.
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Biography
T. R. Fenton is a professor, Community Health Sciences, Institute of Public Health, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada, and Professor, Canada Nutrition Services, Alberta Health Services, Calgary, Alberta, Canada.
Biography
S. Groh-Wargo is a senior nutritionist and professor, Departments of Nutrition and Pediatrics, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH.
Biography
K. Gura is a manager, Clinical Research Program, Department of Pharmacy, Boston Children’s Hospital, Boston, MA.
Biography
C. R. Martin is an associate professor of pediatrics, Harvard Medical School, Boston, MA, associate director, Neonatal Intensive Care Unit, Department of Neonatology, and director for cross-disciplinary research partnerships, Division of Translational Research, Beth Israel Deaconess Medical Center, Boston, MA
Biography
S. N. Taylor is director of clinical research, Division of Neonatology, and associate professor, Department of Pediatrics, Yale School of Medicine, New Haven, CT.
Biography
I. J. Griffin is director, Clinical and Translational Research, Biomedical Research Institute of New Jersey, Cedar Knolls, NJ, and Neonatologist, Department of Pediatrics, Morristown Medical Center, Morristown, NJ.
Biography
M. Rozga is a nutrition researcher, Academy of Nutrition and Dietetics, Evidence Analysis Center, Chicago, IL.
Biography
L. Moloney is a nutrition researcher, Academy of Nutrition and Dietetics, Evidence Analysis Center, Chicago, IL.
Article info
Publication history
Published online: December 22, 2020
Accepted:
November 3,
2020
Received:
June 4,
2020
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was supported by the Academy of Nutrition and Dietetics.
AUTHOR CONTRIBUTIONS All authors were involved developing this systematic review from question formulation to evidence grading. T. R. Fenton, S. Groh-Wargo, and M. Rozga wrote the first draft of this manuscript and all authors reviewed and commented on subsequent drafts of the manuscript.
Identification
Copyright
© 2021 by the Academy of Nutrition and Dietetics.
