No benefit for inositol supplementation in preterm infants

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.

Limitations

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