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Developmental outcome of preterm infants after surfactant therapy: Systematic review of randomized controlled trials
Author(s) -
Sinn JKH,
Ward MC,
HendersonSmart DJ
Publication year - 2002
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.2002.00061.x
Subject(s) - medicine , randomized controlled trial , odds ratio , pediatrics , meta analysis , surfactant therapy , adverse effect , mortality rate , gestational age , pregnancy , biology , genetics
Objectives: To review neuro‐developmental outcome at 1 and 2 years of age following randomized controlled trials (RCT) of neonatal surfactant therapy. Methods: A systematic review of the MEDLINE, Embase and Cochrane Controlled Trial Register databases, searching for RCT of surfactant replacement therapy with follow‐up outcomes, was carried out. The main outcome measures were severe and mild disability at 1 and 2 years plus composite adverse outcome of death and/or severe disability. Results: A meta‐analysis using odds ratios was carried out on 13 RCT. There were a total of 2218 treated and 2090 control infants who underwent follow up at 1 year of age. There were 303 treated and 292 control infants with follow up at between 18 months and 2 years of age. Surfactant therapy was associated with a lower rate of mild disability at 1 year (OR 0.79; 95% CI 0.66−0.95). There was a reduction in the combined adverse outcome (death or severe disability rate) at 1 year (OR 0.8; 95% CI 0.72−0.89). Neither the 1 year nor the 2 year follow‐up examination showed a statistical difference in the severe disability rate between the control and treated group. Conclusion: Surfactant therapy increases survival without an increase in subsequent morbidity at 1 and 2 years of age.