Neonatal Intensive Care Unit, Dongguan People's Hospital, Dongguan 523000, Guangdong Province, P.R. China.
Medicine (Baltimore). 2021 Jan 22;100(3):e23101. doi: 10.1097/MD.0000000000023101.
It is necessary to evaluate the effectiveness and safety of vitamin A supplementation on the bronchopulmonary dysplasia (BPD) in premature infants.
Randomized controlled trials (RCTs) on the role of supplemental vitamin A in preterm infants were searched. The Medline et al databases were manually searched from inception to April 30, 2020. Related outcomes including incidence of BPD, retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), sepsis and mortality were assessed with Review Manager 5.3 software, and Random-effect model was applied for all conditions.
A total of 9 RCTs with 1409 patients were included. The analyzed results showed that the incidence of BPD in vitamin A group was significantly less than that of control group (OR = 0.67, 95%CI [0.52-0.88]). There was no significant difference in the incidence of ROP (OR = 0.65, 95%CI [0.29-1.48]), NEC (OR = 0.88, 95%CI [0.59-1.30]), IVH (OR = 0.90, 95%CI [0.65-1.25]), sepsis (OR = 0.84, 95%CI [0.64-1.09]) and mortality (OR = 0.98, 95%CI [0.72-1.34]) among two groups.
Vitamin A supplementation is beneficial to the prophylaxis of BPD in premature infants, further studies on the administration approaches and dosages of vitamin A in premature infants are warranted.
评估补充维生素 A 对早产儿支气管肺发育不良（BPD）的有效性和安全性是必要的。
检索了关于补充维生素 A 在早产儿中的作用的随机对照试验（RCT）。从 2020 年 4 月 30 日起，手工检索了 Medline 等数据库。使用 Review Manager 5.3 软件评估了包括 BPD、早产儿视网膜病变（ROP）、坏死性小肠结肠炎（NEC）、脑室内出血（IVH）、败血症和死亡率在内的相关结局，所有情况均采用随机效应模型。
共纳入 9 项 RCT，共 1409 例患者。分析结果显示，维生素 A 组 BPD 发生率明显低于对照组（OR=0.67，95%CI[0.52-0.88]）。ROP 发生率（OR=0.65，95%CI[0.29-1.48]）、NEC（OR=0.88，95%CI[0.59-1.30]）、IVH（OR=0.90，95%CI[0.65-1.25]）、败血症（OR=0.84，95%CI[0.64-1.09]）和死亡率（OR=0.98，95%CI[0.72-1.34]）两组间无显著差异。
补充维生素 A 有利于预防早产儿 BPD，有必要进一步研究早产儿维生素 A 的给药途径和剂量。
