Early drug treatment in preterm patients with large patent ductus arteriosus at 28 weeks or less gestational age: systematic review and meta-analysis.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2024-10-17 DOI:10.1038/s41372-024-02154-4

Gabriel Erzinger, Gokul Rajith, Matheus H Torres, Mateus de Miranda Gauza, Zeeshan Mansuri, Silvia M Cardoso

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引用次数: 0

Abstract

Objective: Compare the use of nonsteroidal anti-inflammatory drugs (NSAIDs) with placebo/expectant management in preterm infants at 28 weeks or less gestational age with a large Patent Ductus (PDA).

Study design: A meta-analysis of RCTs following PRISMA guidelines comparing the use of NSAIDs with placebo/expectant management in extremely preterm infants with a large PDA.

Results: There were no significant differences between the NSAIDs and placebo/expectant groups for all-cause mortality (RR 1.27; 95% CI 0.97-1.65; p = 0.081). However, the ibuprofen subgroup showed a significant difference in all-cause mortality (RR 1.36; 95% CI 1.03-1.80; p = 0.03) favoring the placebo/expectant group.

Conclusion: In extremely preterm infants with a large PDA on ultrasound, early treatment with NSAIDs provides no additional clinical benefit compared to placebo/expectant treatment. Ibuprofen was associated with an increased risk ratio for all-cause mortality in the subgroup analysis.

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胎龄 28 周或不足 28 周的大动脉导管未闭早产儿的早期药物治疗：系统综述和荟萃分析。

目的比较非甾体类抗炎药（NSAIDs）与安慰剂/期待疗法在胎龄 28 周或不足 28 周、伴有巨大动脉导管未闭（PDA）的早产儿中的应用：研究设计：根据PRISMA指南对RCT进行荟萃分析，比较在患有巨大PDA的极早产儿中使用非甾体抗炎药与安慰剂/期待疗法的效果：在全因死亡率方面，非甾体抗炎药组与安慰剂组/期待组之间无明显差异（RR 1.27；95% CI 0.97-1.65；P = 0.081）。然而，布洛芬亚组在全因死亡率方面显示出显著差异（RR 1.36；95% CI 1.03-1.80；p = 0.03），安慰剂/预期组更胜一筹：结论：对于超声检查发现有巨大PDA的极早产儿，非甾体抗炎药的早期治疗与安慰剂/期待治疗相比不会带来额外的临床益处。在亚组分析中，布洛芬与全因死亡率风险比升高有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.