Department of Pediatric Research, Oslo University Hospital, University of Oslo, Oslo, Norway.
Neonatology. 2012;102(2):98-103. doi: 10.1159/000333346. Epub 2012 Jun 5.
The use of air for the initial resuscitation of newborn infants has been shown to reduce neonatal mortality. However, a precise estimate of the neurodevelopmental status upon follow-up of infants resuscitated in air is lacking.
To perform a meta-analysis of all studies reporting resuscitation of newborn infants with air or 100% oxygen that included follow-up data.
Bibliographic databases were searched. In addition, we estimated the effect of loss to follow-up on our analysis of abnormal neurodevelopmental outcome.
We identified 10 studies in which newborn infants had been randomly or quasi-randomly assigned to resuscitation with air or 100% oxygen. Three of these 10 studies had available follow-up data. A total of 678 infants were enrolled at centers that performed follow-up of these infants. Of these, 113 died, leaving 565 infants potentially eligible for follow-up. A total of 414 children were evaluated (73% of eligible children; 195 resuscitated with air and 219 with 100% oxygen). In the air group, 12.8% of infants had an abnormal neurodevelopmental outcome, compared with 10.5% in the 100% oxygen group [typical relative risk (RR) 1.24, 95% confidence interval 0.73-2.10]. This is consistent with an RR of abnormal development as low as 0.41 or as high as 2.28.
Long-term follow-up did not detect any significant differences in these two groups regarding abnormal development. However, the results are imprecise and could be consistent with significant harm or benefit.
使用空气进行新生儿初始复苏已被证明可降低新生儿死亡率。然而，对于在空气复苏的婴儿进行随访时的神经发育状况的精确估计尚缺乏研究。
对所有报告使用空气或 100%氧气复苏新生儿并包含随访数据的研究进行荟萃分析。
检索文献数据库。此外，我们还估计了失访对我们分析异常神经发育结局的影响。
我们确定了 10 项研究，这些研究中新生儿被随机或半随机分配接受空气或 100%氧气复苏。其中 3 项研究有随访数据。这些研究中心共纳入了 678 名新生儿。其中 113 名死亡，565 名婴儿可能有随访数据。共有 414 名儿童接受了评估（占合格儿童的 73%；195 名接受空气复苏，219 名接受 100%氧气复苏）。在空气组中，12.8%的婴儿存在异常神经发育结局，而在 100%氧气组中为 10.5%[典型相对风险（RR）1.24，95%置信区间 0.73-2.10]。这与异常发育的 RR 低至 0.41 或高至 2.28 的结果一致。
长期随访未发现这两组在异常发育方面有任何显著差异。然而，结果不够精确，可能与显著的危害或益处相一致。
