School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
Department of Ophthalmology, Peking University People's Hospital, Beijing, China.
Eye (Lond). 2024 Apr;38(5):877-884. doi: 10.1038/s41433-023-02796-2. Epub 2023 Oct 18.
The objective of this study was to evaluate the comparative efficacy of current interventions for the prevention of retinopathy of prematurity (ROP) in premature infants.
A network meta-analysis (NMA) was performed. We searched PubMed, Web of Science, Scopus, Embase, and the Cochrane Library for relevant studies from their inception to May 5, 2022. Publications were eligible for our study if they were randomized controlled trials (RCTs) involving preterm infants at <37 weeks of gestational age and reported the incidence of any-stage ROP treated with the interventions of interest. The overall effect was pooled using the random effects model.
We identified 106 RCTs (involving 23894 participants). This NMA showed that vitamin A supplementation markedly reduced the incidence of ROP, in comparison with placebo (odds ratio [OR] = 0.59, 95% credible interval [95% CrI] 0.33, 0.85), fish oil-based lipid emulsion (OR = 0.57, 95% CrI 0.24, 0.90), early erythropoietin (OR = 0.51, 95% CrI 0.34, 0.98), probiotics (OR = 0.48, 95% CrI 0.32, 0.97), and human milk (OR = 0.50, 95% CrI 0.21, 0.78). Vitamin A supplementation has the highest probability of being the best option for reducing the ROP risk compared with the other 20 interventions based on its surface under the cumulative ranking curve (SUCRA) value (SUCRA = 92.50%, 95% CrI 0.71, 1.00).
Our findings suggest that among 21 interventions, vitamin A supplementation might be the best method of preventing ROP. This NMA offers an important resource for further efforts to develop preventive strategies for ROP.
本研究旨在评估当前预防早产儿视网膜病变（ROP）的干预措施的比较疗效。
进行了一项网络荟萃分析（NMA）。我们从成立到 2022 年 5 月 5 日，在 PubMed、Web of Science、Scopus、Embase 和 Cochrane Library 中搜索了相关研究。如果研究为涉及胎龄<37 周的早产儿的随机对照试验（RCT），并报告了用感兴趣的干预措施治疗的任何阶段 ROP 的发生率，则将其纳入研究。使用随机效应模型汇总总体效果。
我们确定了 106 项 RCT（涉及 23894 名参与者）。这项 NMA 表明，与安慰剂相比，维生素 A 补充剂可显著降低 ROP 的发生率（比值比 [OR] = 0.59，95%可信区间 [95% CrI] 0.33，0.85）、鱼油为基础的脂质乳剂（OR = 0.57，95% CrI 0.24，0.90）、早期促红细胞生成素（OR = 0.51，95% CrI 0.34，0.98）、益生菌（OR = 0.48，95% CrI 0.32，0.97）和人乳（OR = 0.50，95% CrI 0.21，0.78）。基于累积排序曲线下面积（SUCRA）值（SUCRA = 92.50%，95% CrI 0.71，1.00），与其他 20 种干预措施相比，维生素 A 补充剂在降低 ROP 风险方面最有可能成为最佳选择。
我们的研究结果表明，在 21 种干预措施中，维生素 A 补充剂可能是预防 ROP 的最佳方法。这项 NMA 为进一步开发 ROP 预防策略提供了重要资源。
