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Table 4 Evidence quality assessment of according to the GRADE guidelines

From: Effectiveness of feeding supplementation in preterm infants: an overview of systematic reviews

First author

Health outcomes

Study limitation

Indirectness

Publication bias

Imprecision

Inconsistency

Confidence

Pammi et al.

Hospital stay ↓

-1

0

0

0

-1

low

urinary tract infection ↓

-1

0

0

0

-1

low

Morbidity: LOS ↓

-1

0

0

0

-1

low

Morbidity: Fungal sepsis ↓

-1

0

0

0

0

moderate

Howlett et al.

Mortality: Neonatal death ↓

0

0

0

0

-1

moderate

Chi et al.

Days achieve full enteral feeding↓

0

0

-1

0

-2

Very low

Hospital stay ↓

0

0

-1

0

-2

Very low

Stool frequency ↑

0

0

-1

-1

0

low

Morbidity: Sepsis ↓

0

0

0

0

0

high

mortality↓

0

0

0

0

0

high

Armannia et al.

Phototherapy rate ↓

-1

0

0

-1

0

low

Hospital stay ↓

-1

0

0

-1

0

low

Stool frequency ↑

0

0

0

0

0

high

Morbidity: Hyperbilirubina-emia ↓

-1

0

0

-1

0

low

Amissah et al.

Weight ↑

-1

0

0

0

-1

low

Length ↑

-1

0

0

0

-1

low

HC↑

-1

0

0

0

-1

low

Blood urea nitrogen ↑

-1

0

0

0

-1

low

Hospital stay ↑

-1

0

0

-2

0

Very low

Amissah et al.

Weight ↑

-1

-1

0

-1

0

Very low

Hospital stay ↓

-1

-1

0

-1

0

Very low

Yang et al.

Length ↑

0

0

0

0

0

high

HC ↑

0

0

0

0

0

high

Ig-A ↑

0

0

0

0

0

high

Ig-G ↑

0

0

-1

-1

0

low

IL-12 ↑

0

0

0

-1

0

moderate

Shah et al.

Morbidity: NEC ↓

0

0

-1

0

0

moderate

Aceti et al.

Morbidity: LOS ↓

0

0

0

0

0

high

Moe-Byrne et al.

Days achieve full enteral feeding ↓

0

0

-1

0

0

moderate

Moon et al.

Weight ↑

0

0

-1

0

-1

low

Length ↑

0

0

-1

0

-1

low

AlFaleh et al.

Hospital stay ↓

-1

0

0

0

-2

Very low

Days achieve full enteral feeding ↓

-1

0

-1

0

-2

Very low

NEC ↓

-1

0

-1

0

0

low

Mortality↓

-2

0

0

-1

0

Very low

Young et al.

Visual acuity↑

0

0

-1

-1

0

low

Bone mineral content (4/12 months) ↑

0

0

-1

-1

0

low

Verner et al.

Intestinal fat absorption ↑

0

0

0

-1

-1

low

  1. LOS Late-onset sepsis; HC Head circumference; NEC Necrotizing enterocolits
  2. Study limitation: Downgraded two level to study risk of bias at two or more points. Downgraded one level to study risk of bias at one point
  3. Indirectness: Downgraded one level due to a conclusion indirectly
  4. Publication bias: Downgraded on level due to funnel plot is not symmetrical or fewer than nine studies were included
  5. Imprecision: Downgraded one level due to uncertainty about precision.
  6. Inconsistency: Downgraded one level due to included studies : 75%≤ I2 ≤100%; Downgraded two level due to included studies: 50≤ I2 < 75%