Abstract：
There is no consensus on optimal nutrition for preterm infants, leading to substantial practice variation. We aimed to assess the quality of nutrition guidelines for preterm infants, the consistency of recommendations, and the gaps in recommendations.
We searched databases and websites for nutrition guidelines for preterm infants before first hospital discharge, which were endorsed, prepared, or authorized by a regional, national, or international body, written in English, and published between 2012 and 2023. Two reviewers independently screened articles and extracted the recommendations. Four reviewers appraised the included guidelines using Appraisal of Guidelines, Research, and Evaluation II.
A total of 7051 were identified, with 27 guidelines included, 26% of which were high in quality. Most guidelines lacked stakeholder involvement and rigor of development. We found considerable variation in recommendations, many of which lacked details on certainty of evidence and strength of recommendation. Recommendations for type of feed and breastmilk fortification were consistent among high-quality guidelines, but recommendations varied for intakes of almost all nutrients and monitoring of nutrition adequacy. Different guidelines gave different certainty of evidence for the same recommendations. Most gaps in recommendations were due to very low certainty of evidence.
Future development of nutrition guidelines for preterm infants should follow the standard guideline development method and ensure the rigorous process, including stakeholders\' involvement, to improve the reporting of strength of recommendation, certainty of evidence, and gaps in recommendation. Evidence is needed to support recommendations about macro and micronutrient intakes, breastmilk fortification, and markers on adequacy of intake of different nutrients.
We searched databases and websites for nutrition guidelines for preterm infants before first hospital discharge, which were endorsed, prepared, or authorized by a regional, national, or international body, written in English, and published between 2012 and 2023. Two reviewers independently screened articles and extracted the recommendations. Four reviewers appraised the included guidelines using Appraisal of Guidelines, Research, and Evaluation II.
A total of 7051 were identified, with 27 guidelines included, 26% of which were high in quality. Most guidelines lacked stakeholder involvement and rigor of development. We found considerable variation in recommendations, many of which lacked details on certainty of evidence and strength of recommendation. Recommendations for type of feed and breastmilk fortification were consistent among high-quality guidelines, but recommendations varied for intakes of almost all nutrients and monitoring of nutrition adequacy. Different guidelines gave different certainty of evidence for the same recommendations. Most gaps in recommendations were due to very low certainty of evidence.
Future development of nutrition guidelines for preterm infants should follow the standard guideline development method and ensure the rigorous process, including stakeholders\' involvement, to improve the reporting of strength of recommendation, certainty of evidence, and gaps in recommendation. Evidence is needed to support recommendations about macro and micronutrient intakes, breastmilk fortification, and markers on adequacy of intake of different nutrients.
摘要：
背景：关于早产儿的最佳营养尚无共识，导致大量的实践变化。我们旨在评估早产儿营养指南的质量，建议的一致性，以及建议中的差距。
方法：我们在数据库和网站上搜索了早产儿首次出院前的营养指南，得到认可，准备好了,或由地区授权，国家,或国际机构，用英语写的,并在2012-2023年间出版。两名审稿人独立筛选文章并提取建议。四名审稿人使用AGREEII评估了所包含的指南。
结果：确定了7051条记录，包括27条准则，其中26%的质量较高。大多数准则缺乏利益相关者的参与和严格的发展。我们发现建议有很大差异，其中许多缺乏证据确定性和推荐力度的细节。关于饲料类型和母乳强化的建议在高质量指南中是一致的，但是对于几乎所有营养素的摄入量和营养充足性的监测，建议各不相同。不同的指南对相同的建议给出了不同的证据确定性。建议中的大多数差距是由于证据的确定性非常低。
结论：未来早产儿营养指南的制定应遵循标准指南制定方法，并确保严格的过程，包括利益相关者的参与，以提高推荐强度的报告。证据的确定性,和建议的差距。需要证据来支持关于宏观和微量营养素摄入量的建议，母乳强化，以及不同营养素摄入充足的标志物。本文受版权保护。保留所有权利。
方法：我们在数据库和网站上搜索了早产儿首次出院前的营养指南，得到认可，准备好了,或由地区授权，国家,或国际机构，用英语写的,并在2012-2023年间出版。两名审稿人独立筛选文章并提取建议。四名审稿人使用AGREEII评估了所包含的指南。
结果：确定了7051条记录，包括27条准则，其中26%的质量较高。大多数准则缺乏利益相关者的参与和严格的发展。我们发现建议有很大差异，其中许多缺乏证据确定性和推荐力度的细节。关于饲料类型和母乳强化的建议在高质量指南中是一致的，但是对于几乎所有营养素的摄入量和营养充足性的监测，建议各不相同。不同的指南对相同的建议给出了不同的证据确定性。建议中的大多数差距是由于证据的确定性非常低。
结论：未来早产儿营养指南的制定应遵循标准指南制定方法，并确保严格的过程，包括利益相关者的参与，以提高推荐强度的报告。证据的确定性,和建议的差距。需要证据来支持关于宏观和微量营养素摄入量的建议，母乳强化，以及不同营养素摄入充足的标志物。本文受版权保护。保留所有权利。
