Mortality and neurodevelopmental outcomes of infants with spontaneous intestinal perforation: a systematic review and meta-analysis.


Journal

Archives of disease in childhood. Fetal and neonatal edition
ISSN: 1468-2052
Titre abrégé: Arch Dis Child Fetal Neonatal Ed
Pays: England
ID NLM: 9501297

Informations de publication

Date de publication:
May 2023
Historique:
received: 17 03 2022
accepted: 06 10 2022
medline: 21 4 2023
pubmed: 4 11 2022
entrez: 3 11 2022
Statut: ppublish

Résumé

There is limited information about the mortality and neurodevelopmental outcomes of very preterm infants (<32 weeks) with spontaneous intestinal perforation (SIP). To explore the association between SIP and neurodevelopmental outcomes and mortality in very preterm infants. Medline, EMBASE, Cochrane Library, EMCARE and MedNar. Databases were searched until September 2021. Studies comparing outcomes of 'SIP' versus 'no SIP or necrotising enterocolitis (NEC)' were included. Neurodevelopmental outcomes at ≥1 year corrected age were extracted as the main outcome measure. Data were pooled separately for adjusted and unadjusted ORs using the random-effects model. The evidence level was assessed using the GRADE (Grading of Recommendations, Assessments, Development and Evaluations) framework. Eighteen cohort studies (13 606 infants) were included. Meta-analysis of unadjusted ORs showed that SIP was significantly associated with increased odds of mortality, cerebral palsy, composite outcome of death or disability, visual impairment and hearing impairment. However, pooling of adjusted ORs (aOR) found significant associations only for mortality (aOR (95% CI) 2.27 (2.07 to 2.49); I Lack of information on aORs from many studies. SIP in very preterm infants is associated with higher odds of mortality, severe disability, and

Sections du résumé

BACKGROUND BACKGROUND
There is limited information about the mortality and neurodevelopmental outcomes of very preterm infants (<32 weeks) with spontaneous intestinal perforation (SIP).
OBJECTIVE OBJECTIVE
To explore the association between SIP and neurodevelopmental outcomes and mortality in very preterm infants.
DATA SOURCES METHODS
Medline, EMBASE, Cochrane Library, EMCARE and MedNar.
STUDY SELECTION METHODS
Databases were searched until September 2021. Studies comparing outcomes of 'SIP' versus 'no SIP or necrotising enterocolitis (NEC)' were included.
DATA EXTRACTION METHODS
Neurodevelopmental outcomes at ≥1 year corrected age were extracted as the main outcome measure. Data were pooled separately for adjusted and unadjusted ORs using the random-effects model. The evidence level was assessed using the GRADE (Grading of Recommendations, Assessments, Development and Evaluations) framework.
RESULTS RESULTS
Eighteen cohort studies (13 606 infants) were included. Meta-analysis of unadjusted ORs showed that SIP was significantly associated with increased odds of mortality, cerebral palsy, composite outcome of death or disability, visual impairment and hearing impairment. However, pooling of adjusted ORs (aOR) found significant associations only for mortality (aOR (95% CI) 2.27 (2.07 to 2.49); I
LIMITATIONS CONCLUSIONS
Lack of information on aORs from many studies.
CONCLUSIONS CONCLUSIONS
SIP in very preterm infants is associated with higher odds of mortality, severe disability, and

Identifiants

pubmed: 36328412
pii: archdischild-2022-324157
doi: 10.1136/archdischild-2022-324157
doi:

Types de publication

Meta-Analysis Systematic Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

256-266

Informations de copyright

© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Ju Li Ang (JL)

Neonatology, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Neonatology, King Edward memorial hospital For Women, Subiaco, Western Australia, Australia.

Chandra Prakash Rath (CP)

Neonatology, Perth Children's Hospital, Nedlands, Western Australia, Australia drcprath@gmail.com.
Neonatology, King Edward memorial hospital For Women, Subiaco, Western Australia, Australia.

Herr Tan (H)

Neonatology, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Neonatology, King Edward memorial hospital For Women, Subiaco, Western Australia, Australia.

Sanjay Patole (S)

Neonatology, King Edward memorial hospital For Women, Subiaco, Western Australia, Australia.
Paediatrics, The University of Western Australia School of Medicine, Nedlands, Western Australia, Australia.

Shripada C Rao (SC)

Neonatology, Perth Children's Hospital, Nedlands, Western Australia, Australia.
Paediatrics, The University of Western Australia School of Medicine, Nedlands, Western Australia, Australia.

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Classifications MeSH