Garg Bhawan Deep, Bansal Anju, Kabra Nandkishor S
Surya Mother and Child Care Super Speciality Hospital, Mumbai, India.
Adarsh Hospital, Sri Ganganagar, India.
J Matern Fetal Neonatal Med. 2019 Dec;32(24):4159-4165. doi: 10.1080/14767058.2018.1481039. Epub 2018 Jun 20.
Neonatal sepsis is one of the most common causes of neonatal morbidity and mortality. Selenium has antioxidant and immune-modulating properties. The aim of this systematic review is to evaluate role of selenium supplementation in the prevention of late onset sepsis (LOS) among very low birth weight (VLBW) neonates. We searched literature for this review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) electronic PubMed, Embase, and Google Scholar. We also searched for ongoing clinical trials. This review included two randomized controlled trials (RCTs) that fulfilled inclusion criteria. There was statistically significant reduction in the incidence of LOS in the intervention group [23.7 versus 35.6%; relative risk (RR) 0.67; 95% CI 0.52-0.86; = .001; number needed to treat (NNT) 8.4; 95% CI 5.2-20.96]. However, mortality due to any cause prior to hospital discharge was not statistically significant in between the groups (6.1% intervention group versus 6.9% control group; RR 0.88; 95% CI 0.49-1.61; = .68). Evidences from current systematic review revealed that selenium supplementation has some role in the prevention of LOS. However, due to limited evidences and heterogeneity between studies, large RCTs are recommended among VLBW neonates.
新生儿败血症是新生儿发病和死亡的最常见原因之一。硒具有抗氧化和免疫调节特性。本系统评价的目的是评估补充硒在预防极低出生体重（VLBW）新生儿晚发性败血症（LOS）中的作用。我们通过检索Cochrane对照试验中心注册库（CENTRAL）、电子PubMed、Embase和谷歌学术搜索来查找本评价的文献。我们还搜索了正在进行的临床试验。本评价纳入了两项符合纳入标准的随机对照试验（RCT）。干预组LOS发病率有统计学显著降低[23.7%对35.6%；相对危险度（RR）0.67；95%可信区间0.52 - 0.86；P = 0.001；需治疗人数（NNT）8.4；95%可信区间5.2 - 20.96]。然而，两组间出院前任何原因导致的死亡率无统计学显著差异（干预组6.1%对对照组6.9%；RR 0.88；95%可信区间0.49 - 1.61；P = 0.68）。当前系统评价的证据表明，补充硒在预防LOS方面有一定作用。然而，由于证据有限且研究间存在异质性，建议在VLBW新生儿中开展大型RCT。
