{
  "abstract": "Objective To compare feeding strategies on preterm infants’ growth during hospitalisation, neonatal morbidities, mortality and neurodevelopmental outcome (NDO) at 18–26 months corrected age.Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension statement for network meta-analysis . We searched five medical databases for randomised controlled trials comparing different feeding approaches in preterm infants and their effects on growth, neonatal morbidities, mortality and NDO. The Cochrane Collaboration’s tool was used to assess the risk of bias. We used a random-effects model. Pooled mean differences (MD) or risk ratios with 95% CIs were calculated.Results Ninety-five studies (9663 infants) were included.Human milk (HM) with bovine milk fortifier (BMF) (adjusted according to blood urea nitrogen) achieved the best length increment (MD=0.56 cm/week; 95% CI 0.19 to 0.93). Notably, HM+BMF (3.5 gm/kg/d protein) showed the best head circumference growth (MD 0.46 cm/week; 95% CI 0.10 to 0.81) but no significant difference in weight gain. There were no significant differences in neonatal morbidities/mortality. While MOM|+PTF (supp) displayed significantly lower NDO delay in the domain of mild cognitive delay.Conclusion Overall, there is a lack of strong evidence to support a specific enteral feeding strategy and further high-quality research is required. Targeted HM fortification appears to improve head growth, while adjusted fortification enhances length. Given the significant inconsistency detected, which may compromise the reliability of the network estimates, these results must be interpreted carefully.",
  "authors": [
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "NICU, El Sahel Teaching Hospital, Cairo, Egypt"
      ],
      "name": "Naema Hamouda"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Zagazig University Faculty Medicine, Zagazig, Ash Sharqia Governorate, Egypt"
      ],
      "name": "Yosra AboEL-Azm"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Biochemistry and Nutrition, Faculty of Women for Science, Ain Shams University, Cairo, Egypt"
      ],
      "name": "Kholoud Elsamman"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Internal Medicine, Beni Suef University Hospital, Beni Suef, Beni Suef Governorate, Egypt"
      ],
      "name": "Soha Nabil"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Al-Azhar University Faculty of Medicine, Nasr City, Cairo, Egypt"
      ],
      "name": "Mohammed Tarek"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Faculty of Medicine Kafrelsheikh University, Kafr El-sheikh, Egypt"
      ],
      "name": "Fatma Elzahraa Wasia"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Al-Azhar University Faculty of Medicine, Nasr City, Cairo, Egypt"
      ],
      "name": "Ahmed Mostafa Amin"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Al-Azhar University Faculty of Medicine, Nasr City, Cairo, Egypt"
      ],
      "name": "Ahmed Elshahat"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Zagazig University Faculty of Human Medicine, Zagazig, Egypt"
      ],
      "name": "Nourhan hassan"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Faculty of Medicine Kutahya Health Science University, Kutahya, Turkey"
      ],
      "name": "Ammar Mektebi"
    },
    {
      "affiliations": [
        "Zagazig University Faculty of Human Medicine, Zagazig, Egypt"
      ],
      "name": "Abdelazem Khaled"
    },
    {
      "affiliations": [
        "South Valley University Faculty of Medicine, Qena, Egypt"
      ],
      "name": "Hatim Nasruldin Shahin"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Sohag University Faculty of Medicine, Sohag, Egypt"
      ],
      "name": "Mohamed A Aldemerdash"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Physical Therapy for Women’s Health, Cairo University Faculty of Physical Therapy, Dokki, Giza, Egypt"
      ],
      "name": "Neveen Refaey"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Zagazig University Faculty of Human Medicine, Zagazig, Egypt"
      ],
      "name": "Mohamed Khalil"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Ain Shams University Faculty of Medicine, Cairo, Egypt"
      ],
      "name": "Nada Ibrahim Hendi"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Minia University Faculty of Medicine, Minia, Egypt"
      ],
      "name": "Somaya Hafez"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "The Hashemite University Faculty of Medicine, Zarqa, Zarqa, Jordan"
      ],
      "name": "Yasmeen Jamal Alabdallat"
    },
    {
      "affiliations": [
        "Negida Research Academy, Arlington, Virginia, USA",
        "Pediatrics and Neonatology, Muscat Private Hospital, Muscat, Muscat, Oman"
      ],
      "name": "Mohammed Abdellatif"
    }
  ],
  "title": "Effect of different feeding approaches on growth, neonatal morbidities, mortality and neurodevelopmental outcome in preterm infants: a systematic review and network meta-analysis",
  "uid": "e00ad670-1b95-5976-8438-67082f3fe6d1"
}