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Meta-Analysis
. 2013 Jan;131(1):e262-72.
doi: 10.1542/peds.2012-0517. Epub 2012 Dec 17.

Meta-analysis of LCPUFA supplementation of infant formula and visual acuity

Affiliations
Meta-Analysis

Meta-analysis of LCPUFA supplementation of infant formula and visual acuity

Ahmad Qawasmi et al. Pediatrics. 2013 Jan.

Abstract

Background and objective: Long-chain polyunsaturated fatty acids (LCPUFAs) are hypothesized to affect visual acuity development in infants. Randomized controlled trials (RCTs) have been conducted to assess whether supplementation of LCPUFAs of infant formulas affects infant visual acuity. This meta-analysis was conducted to evaluate whether LCPUFA supplementation of infant formulas improves infants' visual acuity.

Methods: PubMed and PsycInfo were searched for RCTs assessing the efficacy of LCPUFA supplementation of infant formulas on infant visual acuity. RCTs assessing the effects of LCPUFA supplementation on visual acuity (by using either visual evoked potential or behavioral methods) in the first year of life were included in this meta-analysis. Our primary outcome was the mean difference in visual resolution acuity (measured in logarithm of minimum angle of resolution [logMAR]) between supplemented and unsupplemented infants. We also conducted secondary subgroup analyses and meta-regression examining the effects of LCPUFA dose and timing, preterm versus term birth status, and trial methodologic quality.

Results: Nineteen studies involving 1949 infants were included. We demonstrated a significant benefit of LCPUFA supplementation on infants' visual acuity at 2, 4, and 12 months of age when visual acuity was assessed by using visual evoked potential and at 2 months of age by using behavioral methods. There was significant heterogeneity between trials but no evidence of publication bias. Secondary analysis failed to show any moderating effects on the association between LCPUFA supplementation and visual acuity.

Conclusions: Current evidence suggests that LCPUFA supplementation of infant formulas improves infants' visual acuity up to 12 months of age.

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Figures

FIGURE 1
FIGURE 1
Selection of eligible trials and reasons for exclusion. Each citation is counted only once for clarity.
FIGURE 2
FIGURE 2
A, Difference in visual acuity as assessed by VEP at the age of 2 months between infants fed formula supplemented with LCPUFAs and nonsupplemented formula. B, Difference in visual acuity as assessed by VEP at the age of 4 months between infants fed formula supplemented with LCPUFAs and nonsupplemented formula. C, Difference in visual acuity as assessed by VEP at the age of 12 months between infants fed formula supplemented with LCPUFAs and nonsupplemented formula.
FIGURE 3
FIGURE 3
A, Difference in visual acuity as assessed by BMs at the age of 2 months between infants fed formula supplemented with LCPUFAs and nonsupplemented formula. B, Difference in visual acuity as assessed by BMs at the age of 4 months between infants fed formula supplemented with LCPUFAs and nonsupplemented formula. C, Difference in visual acuity as assessed by BMs at the age of 12 months between infants fed formula supplemented with LCPUFAs and nonsupplemented formula.
FIGURE 3
FIGURE 3
A, Difference in visual acuity as assessed by BMs at the age of 2 months between infants fed formula supplemented with LCPUFAs and nonsupplemented formula. B, Difference in visual acuity as assessed by BMs at the age of 4 months between infants fed formula supplemented with LCPUFAs and nonsupplemented formula. C, Difference in visual acuity as assessed by BMs at the age of 12 months between infants fed formula supplemented with LCPUFAs and nonsupplemented formula.

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