Effect of Early Erythropoietin on Retinopathy of Prematurity: A Stratified Meta-Analysis.

IF 2.6 3区医学 Q1 PEDIATRICS

Neonatology Pub Date : 2023-01-01 Epub Date: 2023-06-27 DOI:10.1159/000530126

Hendrik S Fischer, Nora J Reibel, Christoph Bührer, Christof Dame

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引用次数: 1

Abstract

Background: Recombinant human erythropoietin (rhEPO) lost its role in minimizing red blood cell transfusion in very preterm infants after it had been associated with severe retinopathy of prematurity (ROP). Previous systematic reviews did not stratify ROP by gestation and birth weight (BW).

Objectives: The aim of this study was to investigate the effect of early prophylactic rhEPO on ROP in a stratified meta-analysis of randomized controlled trials (RCTs).

Methods: The databases EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials were searched in January 2022 and complemented by citation searching. RCTs comparing early rhEPO treatment with no treatment or placebo were selected if they were published in a peer-reviewed journal and reported ROP outcomes. Previously unpublished data were requested from the study authors to allow stratified analyses by gestational age (GA) and BW. Data were extracted and analyzed using the standard methods of the Cochrane Neonatal Review Group. Pre-specified outcomes were "ROP stage ≥3" (primary outcome) and "any ROP."

Results: Fourteen RCTs, comprising 2,040 infants of <29 weeks of GA, were included for meta-analysis. Data syntheses showed no effects of rhEPO on ROP stage ≥3 or on any ROP, neither in infants of <29 weeks GA, nor in infants of <1,000 g BW, nor in any GA strata. The risk ratio (95% confidence interval) for ROP stage ≥3 in infants of <29 weeks of GA was 1.13 (0.84, 1.53), p = 0.41 (quality of evidence: moderate).

Conclusions: The present meta-analysis detected no effects of early rhEPO on ROP in any comparison, but most stratified analyses were limited by low statistical power.

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早期红细胞生成素对早产视网膜病变的影响：分层荟萃分析。

背景：重组人红细胞生成素（rhEPO）在与严重的早产儿视网膜病变（ROP）相关后，在极早产儿中失去了最大限度减少红细胞输注的作用。先前的系统综述没有根据妊娠和出生体重（BW）对ROP进行分层。目的：本研究的目的是在随机对照试验（RCTs）的分层荟萃分析中研究早期预防性rhEPO对ROP的影响。方法：数据库EMBASE、MEDLINE、，2022年1月检索了Cochrane对照试验中央登记册，并辅以引文检索。如果在同行评审期刊上发表并报告了ROP结果，则选择比较早期rhEPO治疗与未治疗或安慰剂的随机对照试验。研究作者要求提供以前未发表的数据，以便按胎龄（GA）和体重进行分层分析。数据采用Cochrane新生儿审查小组的标准方法进行提取和分析。预先指定的结果为“ROP≥3期”（主要结果）和“任何ROP”。结果：14项随机对照试验，包括2040名<；29周的GA纳入荟萃分析。数据综合显示，rhEPO对ROP≥3期或任何ROP均无影响，<；29周GA，<；1000g BW，也不存在于任何GA地层中。<；29周的GA为1.13（0.84,1.53），p=0.41（证据质量：中等）。结论：本荟萃分析在任何比较中都没有发现早期rhEPO对ROP的影响，但大多数分层分析都受到低统计能力的限制。

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

Neonatology 医学-小儿科

CiteScore

0.60

自引率

4.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This highly respected and frequently cited journal is a prime source of information in the area of fetal and neonatal research. Original papers present research on all aspects of neonatology, fetal medicine and developmental biology. These papers encompass both basic science and clinical research including randomized trials, observational studies and epidemiology. Basic science research covers molecular biology, molecular genetics, physiology, biochemistry and pharmacology in fetal and neonatal life. In addition to the classic features the journal accepts papers for the sections Research Briefings and Sources of Neonatal Medicine (historical pieces). Papers reporting results of animal studies should be based upon hypotheses that relate to developmental processes or disorders in the human fetus or neonate.