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Long‐term effects of the intratracheal administration of corticosteroids for the prevention of bronchopulmonary dysplasia: A meta‐analysis
Author(s) -
Zheng Yirong,
Xiu Wenlong,
Lin Yunfeng,
Ren Yanli,
Zhang Baoquan,
Yang Changyi
Publication year - 2019
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24452
Subject(s) - medicine , bronchopulmonary dysplasia , meta analysis , randomized controlled trial , cochrane library , relative risk , incidence (geometry) , adverse effect , pediatrics , confidence interval , gestational age , pregnancy , genetics , physics , optics , biology
Background Bronchopulmonary dysplasia (BPD) is one of the most common complications in premature infants. Since inflammation plays a crucial role in the pathogenesis of BPD, anti‐inflammatory drugs, such as corticosteroids, have long been the focus of prevention research. In this meta‐analysis, we aim to explore the long‐term effects of the intratracheal administration of corticosteroids (IAC) in preventing BPD. Methods EMBASE, MEDLINE, the Cochrane Library, Web of Science, CINAHL, Clinicaltrials.gov, the ISRCTN registry, and gray literature were searched to identify randomized controlled trials (RCTs) that evaluated the long‐term effects of IAC for the prevention of BPD in premature infants. Results Five RCTs (n = 1515) were eligible for further analysis. The meta‐analysis revealed that the incidence of neurodevelopmental impairment (NDI) did not significantly differ between the IAC group and the control group (relative risk [RR] 0.9, 95% confidence interval [CI] 0.79 to 1.03, P = .14). There was no significant reduction in long‐term mortality (RR, 1.13; 95% CI, 0.9 to 1.41; P = .3) or the incidence of rehospitalization (RR, 0.99; 95% CI, 0.89 to 1.09, P = .82). No significant differences were observed between the IAC group and the control group with regard to height, weight and head circumference at the age of 18 to 36 months of postmenstrual age (PMA) (mean difference [MD], 0.14; 95% CI, −0.26 to 0.54, P = .48). Conclusions Our study suggests that IAC in preterm infants does not have significant long‐term benefits or adverse outcomes. However, before routine use, well‐designed studies and studies involving large sample sizes are needed to confirm the pharmacokinetics and long‐term effects of IAC.