Meta AnalysisID 2823
吲哚美辛、布洛芬和对乙酰氨基酚的使用与胎龄<37周且出生体重<2.5 kg早产儿自发性肠穿孔的关联：一项系统评价和Meta分析
CRD42017058603
To assess the relationship between use of intravenous, oral or rectal indomethacin, ibuprofen and acetaminophen and the development of spontaneous intestinal perforation in preterm babies.
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Record Fields
Scalar fields from the final meta_analysis record.
- Meta Analysis Id
- 2823
- Evidence Id
- 11381
- Core Evidence Id
- 11381
- Source Meta Analysis Id
- 2767
- Herb2 Meta Analysis Id
- HBMA002767
- Crd Id
- CRD42017058603
- Title
- Association between use of indomethacin, ibuprofen and acetaminophen with spontaneous intestinal perforation in preterm infants <37 weeks gestational and birth weight < 2.5 kg: a systematic review and meta-analysis
- Review Question
- To assess the relationship between use of intravenous, oral or rectal indomethacin, ibuprofen and acetaminophen and the development of spontaneous intestinal perforation in preterm babies.
- Study Type Included
- The following types of study will be included: 1. Randomized Controlled Trials 2. Controlled Trials 3. Cohort studies 4. Case control 5. Case Series 6. Case reports
- Condition Being Studied
- Spontaneous intestinal perforation (SIP) in preterm newborns is recognized as a separate entity. The clinical course, treatment and prognosis is very different from necrotizing enterocolitis (NEC). The etiology of the condition is not well defined. Various factors have been proposed to contribute to the pathogenesis of SIP, including circulatory insufficiency, umbilical catheters, coagulase negative staphylococcal infection, and congenital defect of the intestinal musculature. It is not a rare condition. It typically affects very low birth weight preterm neonates. It accounts for 44% of gastrointestinal tract perforations in very low birth weight preterm neonates. Patent ductus arteriosus is a very common condition in this population of neonates, for which indomethacin, ibuprofen or acetaminophen are used either prophylactically, or as treatment. From previous studies we know that concomitant use of indomethacin and dexamethasone increase the risk of spontaneous intestinal perforation. There is an increased risk of developing intestinal perforation when exposed these medications but so far the data collected from different studies have mixed together the population affected by NEC with the population affected by SIP. There has not been any systematic review as far as we know to examine the relationship between the development of SIP and exposure to these medications. By this review we hope to identify any association between the two. And by eliminating the NEC variable, we might find other risk factors related to development of SIP, or a different correlation between the 3 medications and the development of SIP.
- Participant
- Studies of preterm (<37 weeks) or body weight < 2,500 gm will be eligible for inclusion.
- Animal
- Human Disease Modelled
- Intervention
- Exposure to the following medication: 1. Indomethacin 2. Ibuprofen 3. Acetaminophen Route of administration: 1. Intravenous 2. Oral 3. Rectal
- Comparator Control
- Comparisons for Randomized Controlled Trials, Controlled Trials and Cohort studies included: · Medication versus placebo · Medication versus a different medication studied · Medication versus the same medication with a comparison of medication dosing or treatment regime such as prophylaxis versus treatment, or number or courses of treatment for example. For Case series and case reports: no comparator Studies to be excluded if: · No SIP or SIP is not defined as a separate entity from NEC · No medication use of interest (indomethacin, ibuprofen, acetaminophen) · Study population is not <37 weeks or body weight < 2, 500 gm · Poster or abstract only
- Main Outcome
- Spontaneous intestinal perforation Measures of effect 1. Radiological or surgical evidence of intestinal perforation 2. Absence of features of necrotising enterocolitis
- Outcome Measure
- Additional Outcome
- 1. Necrotizing enterocolitis 2. Acute renal injury 3. Death before discharge 4. Intraventricular hemorrhage 5. Patent Ductus Arteriosus ligation 6. Retinopathy of prematurity 7. Bronchopulmonary dysplasia 8. Steroid use (antenatal and postnatal) 9. Antenatal indomethacin use 10. Antenatal Magnesium Sulfate use
- Study Method
- Systematic review
- Keyword
- Acetaminophen; Anti-Inflammatory Agents, Non-Steroidal; Birth Weight; Ductus Arteriosus, Patent; Humans; Ibuprofen; Indomethacin; Infant; Infant, Newborn; Infant, Premature; Intestinal Perforation
- Contact
- Dr. Emanuela Ferretti [email protected]
- Organisational Affiliation
- Funding Source
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- Canada
- Review Stage
- Review Ongoing
- First Submission Date
- 2021-06-19
- Registration Date
- 2017-03-21
- Anticipated Start Date
- 2016-09-29
- Anticipated Completion Date
- 2021-08-01
- Title Cn
- 吲哚美辛、布洛芬和对乙酰氨基酚的使用与胎龄<37周且出生体重<2.5 kg早产儿自发性肠穿孔的关联：一项系统评价和Meta分析
- Title En
- Association between use of indomethacin, ibuprofen and acetaminophen with spontaneous intestinal perforation in preterm infants <37 weeks gestational and birth weight < 2.5 kg: a systematic review and meta-analysis
- Bilingual Status
- complete