Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jul 2015
Review Meta AnalysisSupplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development.
Long chain polyunsaturated fatty acids (LCPUFA), especially docosahexaenoic acid (DHA), are the most abundant fatty acids in the brain and are necessary for growth and maturation of an infant's brain and retina. LCPUFAs are named "essential" because they cannot be synthesised efficiently by the human body and come from maternal diet. It remains controversial whether LCPUFA supplementation to breastfeeding mothers is beneficial for the development of their infants. ⋯ Based on the available evidence, LCPUFA supplementation did not appear to improve children's neurodevelopment, visual acuity or growth. In child attention at five years of age, weak evidence was found (one study) favouring the supplementation. Currently, there is inconclusive evidence to support or refute the practice of giving LCPUFA supplementation to breastfeeding mothers in order to improve neurodevelopment or visual acuity.
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Cochrane Db Syst Rev · Jul 2015
Review Meta AnalysisInterventions for preventing the progression of autosomal dominant polycystic kidney disease.
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited disorder causing kidney disease. Current clinical management of ADPKD focuses primarily on symptom control and reducing associated complications, particularly hypertension. In recent years, improved understanding of molecular and cellular mechanisms involved in kidney cyst growth and disease progression has resulted in new pharmaceutical agents to target disease pathogenesis to prevent progressive disease. ⋯ Although several interventions are available for patients with ADPKD, at present there is little or no evidence that treatment improves patient outcomes in this population and is associated with frequent adverse effects. Additional large randomised studies focused on patient-centred outcomes are needed.
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Cochrane Db Syst Rev · Jul 2015
ReviewDirected preconception health programs and interventions for improving pregnancy outcomes for women who are overweight or obese.
Overweight and obesity (body mass index (BMI) ≥ 25.0 to 29.9 kg/m(2) and BMI ≥ 30 kg/m(2,) respectively are increasingly common among women of reproductive age. Overweight and obesity are known to be associated with many adverse health conditions in the preconception period, during pregnancy and during the labour and postpartum period. There are no current guidelines to suggest which preconception health programs and interventions are of benefit to these women and their infants. It is important to evaluate the available evidence to establish which preconception interventions are of value to this population of women. ⋯ We found no randomised controlled trials that assessed the effect of preconception health programs and interventions in overweight and obese women with the aim of improving pregnancy outcomes. Until the effectiveness of preconception health programs and interventions can be established, no practice recommendations can be made. Further research is required in this area.
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Cochrane Db Syst Rev · Jul 2015
ReviewEarly discharge with home support of gavage feeding for stable preterm infants who have not established full oral feeds.
Early discharge of stable preterm infants still requiring gavage feeds offers the benefits of uniting families sooner and reducing healthcare and family costs compared with discharge home when on full sucking feeds. Potential disadvantages of early discharge include increased care burden for the family and risk of complications related to gavage feeding. ⋯ Experimental evidence on the benefits and risks for preterm infants of early discharge from hospital with home gavage feeding compared with later discharge upon attainment of full sucking feeds is limited to the results of one small quasi-randomised controlled trial. High-quality trials with concealed allocation, complete follow-up of all randomly assigned infants and adequate sample size are needed before practice recommendations can be made.
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Cochrane Db Syst Rev · Jul 2015
Review Meta AnalysisLuteal phase support for assisted reproduction cycles.
Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin(hCG) produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques(ART), progesterone and/or hCG levels are low, so the luteal phase is supported with progesterone, hCG or gonadotropin-releasing hormone (GnRH) agonists to improve implantation and pregnancy rates. ⋯ Both progesterone and hCG during the luteal phase are associated with higher rates of live birth or ongoing pregnancy than placebo.The addition of GnRHa to progesterone is associated with an improvement in pregnancy outcomes. OHSS rates are increased with hCG compared to placebo (only study only). The addition of oestrogen does not seem to improve outcomes. The route of progester one administration is not associated with an improvement in outcomes.