Elgenidy Anas, Atef Abdelsattar Ibrahim Hoda, Elmozugi Taher, Abdelhalim Nagham N, Al-Kurdi Mohammed A, Wassef Paula G, Zakaria Carolin G, Elsalamony Yomna A, Nasr Mohamed, Abodaif Asmaa, Hussein Abdelrahman, Hassan Abd-El-Monem, Ahmad Ahmad Roshdy, Elhoufey Amira, Fageeh Mohsen, Alruwaili Thamer A M, Dailah Hamad Ghaleb, Temsah Mohamad-Hani, Saad Khaled
Faculty of Medicine, Cairo University, Cairo, Egypt.
Departments of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4947-4955. doi: 10.1007/s00210-024-03681-9. Epub 2024 Dec 21.
The purpose of this study was to systematically review the available literature evaluating the use of melatonin for preventing and treating neonatal necrotizing enterocolitis (NEC). A systematic review of studies examining the effect of melatonin on neonatal NEC was conducted. The databases of Medline, Scopus, WOS, Embase, and Cochrane Central Register of Controlled Trials were searched for relevant studies. For risk of bias and applicability, The ROB2 tool was used for randomized controlled trials, and the ROBINS-I tool was used for non-randomized controlled trials. Three studies, comprising 106 preterm neonates, were included in the review, whose mean gestational ages ranged from 31.8 to 33.53 weeks. Melatonin doses varied among the studies. A randomized, double-blind, placebo-controlled study revealed that early administration of melatonin in preterm newborns resulted in a decrease in lipid peroxidation during the initial days of life. Two studies evaluated the role of melatonin in NEC. Both reported significant clinical and laboratory improvements in the melatonin groups, including reduced abdominal distension, metabolic acidosis, thrombocytopenia, hyponatremia, and lower mortality rates compared to control groups. This systematic review suggests that melatonin may be a potential therapeutic approach for NEC in preterm infants. However, further RCTS are needed to establish its therapeutic or preventive role.
本研究的目的是系统回顾现有文献，评估褪黑素用于预防和治疗新生儿坏死性小肠结肠炎（NEC）的情况。对研究褪黑素对新生儿坏死性小肠结肠炎影响的研究进行了系统回顾。检索了Medline、Scopus、WOS、Embase和Cochrane对照试验中央注册库等数据库中的相关研究。对于偏倚风险和适用性，随机对照试验使用ROB2工具，非随机对照试验使用ROBINS-I工具。该综述纳入了三项研究，共106名早产儿，其平均胎龄在31.8至33.53周之间。各研究中的褪黑素剂量有所不同。一项随机、双盲、安慰剂对照研究表明，早产新生儿早期给予褪黑素可使出生后最初几天的脂质过氧化减少。两项研究评估了褪黑素在坏死性小肠结肠炎中的作用。两项研究均报告褪黑素组在临床和实验室指标方面有显著改善，包括与对照组相比腹胀减轻、代谢性酸中毒、血小板减少、低钠血症及死亡率降低。该系统综述表明，褪黑素可能是治疗早产儿坏死性小肠结肠炎的一种潜在方法。然而，需要进一步的随机对照试验来确定其治疗或预防作用。
