No benefit for inositol supplementation in preterm infants

  • Howlett A & al.
  • Cochrane Database Syst Rev
  • 8 Jul 2019

  • International Clinical Digest
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  • Inositol supplementation offers no detectable reduction for preterm infant risk for most retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) grade 3/4, sepsis, or necrotizing enterocolitis.
  • This Cochrane review relies largely on 2 recent randomized controlled trials.

Why this matters

  • The authors say that inositol supplementation does not have sufficient support for routine nutritional management in these infants, regardless of their respiratory distress syndrome status.
  • This review updates a 2015 analysis , which at the time viewed the evidence as “promising”; the authors say their current results argue against inositol supplementation and that infants in these studies need long-term follow-up.

Key results

  • Although neonatal mortality reduction was associated with inositol supplementation (typical risk ratio [RR], 0.53; 95% CI, 0.31-0.91; 11 needed to benefit), infant deaths were not (typical RR, 0.89; 95% CI, 0.71-1.13), with low-quality evidence.
  • No significant reductions for any ROP, necrotizing enterocolitis, sepsis, IVH grade 2+, bronchopulmonary dysplasia.
  • 1 included study was terminated because of higher mortality rates in the inositol group. 

Study design

  • Analysis of 6 randomized controlled trials with 1177 infants.
  • Funding: Izaak Walton Killam Health Center, Nova Scotia, Canada; Mount Sinai Hospital, Toronto; Vermont Oxford Network, USA.


  • The included studies had serious or very serious limitations, the authors say.

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