Infant Formula for the Prevention and Treatment of Neonatal Hypoglycaemia: A Systematic Review and Meta-Analysis.

AIM: Neonatal hypoglycaemia is a common metabolic disorder in newborns; if severe or prolonged, it can lead to brain injury. Formula is sometimes used to treat neonatal hypoglycaemia. This study aims to synthesise evidence on the effectiveness of infant formula for the prevention and treatment of neonatal hypoglycaemia. METHODS: Randomised controlled trials (RCTs) and cohort studies comparing infants given formula to those who were not were included. Four databases and four trial registries were searched. Study quality was evaluated using the Cochrane Risk of Bias-1 tool for RCTs and the Newcastle-Ottawa Scale for cohort studies. RESULTS: We screened titles and abstracts of 6711 records and full texts of 56 records. We included 12 studies: one RCT and 11 cohort studies. For prevention, the evidence is very uncertain about the effect of formula on neonatal hypoglycaemia (621 infants, OR 3.01 [0.53 to 17.13], p = 0.21, I2 = 85%, very low certainty evidence). One RCT showed that formula may be more likely to correct neonatal hypoglycaemia than oral dextrose gel (222 infants, RR 1.27 [1.11 to 1.46], p = 0.0004, low certainty evidence). CONCLUSIONS: The effect of formula in preventing neonatal hypoglycaemia remains uncertain; although formula may be more effective than oral dextrose gel in correcting hypoglycaemia. TRIAL REGISTRATION: This review was registered in PROSPERO (CRD42024581348).