Meta AnalysisID 3538
新生儿硫酸镁用于神经保护：系统评价
CRD42022346545
To determine the effects of neonatal magnesium sulphate on death and long-term neurodevelopmental disability, and to ascertain clinically important adverse effects in perinatal asphyxia and HIE.
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Record Fields
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- Meta Analysis Id
- 3538
- Evidence Id
- 12096
- Core Evidence Id
- 12096
- Source Meta Analysis Id
- 3494
- Herb2 Meta Analysis Id
- HBMA003494
- Crd Id
- CRD42022346545
- Title
- Neonatal magnesium sulphate for neuroprotection: a systematic review.
- Review Question
- To determine the effects of neonatal magnesium sulphate on death and long-term neurodevelopmental disability, and to ascertain clinically important adverse effects in perinatal asphyxia and HIE.
- Study Type Included
- We will include randomised and quasi-randomised controlled trials, as well as non-randomised controlled studies (non-randomised trials, cohort studies and case-control studies). We will exclude cross-sectional studies, case series and case reports. We will include studies available as abstracts only, along with full-text publications.
- Condition Being Studied
- Neonatal encephalopathy (NE) is a complex neurologic syndrome in term and late preterm babies, who demonstrate difficulty initiating and maintaining respiration, depression of consciousness, and of tone or reflexes, and seizures. It is associated with a high risk of mortality; for those neonates who survive, it is a strong predictor of long-term neurodevelopmental disability, including cerebral palsy. The subset of NE with clear evidence of intrapartum insult (including a sentinel event, depressed Apgar scores and acidaemia) has traditionally been referred to as ‘hypoxic ischaemic encephalopathy’ (HIE). It is estimated that 8.5 babies per 1, 000 livebirths (or 1.15 million babies each year) develop NE associated with intrapartum events, and that 96% of these neonates are born in low- and middle-income countries (LMICs). The NE incidence specifically in high-income regions is substantially lower, at 1.6 babies per 1, 000 livebirths. Of the estimated 1 million worldwide deaths caused by NE each year, 99% occur in LMICs.
- Participant
- We will include neonates with evidence of perinatal asphyxia and/or treated for HIE ≥ 35 weeks’ gestation. To capture the totality of evidence to date, we will include neonates irrespective of the criteria for evidence of asphyxia and/or definition used for HIE. However, we will record all relevant data for reporting and possible subgroup/sensitivity analyses.
- Animal
- Human Disease Modelled
- Intervention
- We will include neonatal magnesium sulphate for the treatment of perinatal asphyxia and HIE, regardless of timing, route of administration, dose, and duration. We will exclude magnesium sulphate for the treatment of persistent pulmonary hypertension of the newborn.
- Comparator Control
- We will include when magnesium sulphate was compared with no treatment, placebo, standard care (such as therapeutic hypothermia (TH)) or an alternative treatment (such as a different magnesium sulphate regimen). We will include when magnesium sulphate was used in combination with TH, or (an) alternate neuroprotective agent(s).
- Main Outcome
- Primary: death; and the composite outcome of death or long-term major neurodevelopmental disability. Secondary: long-term major neurodevelopmental disability composite; individual components of long-term major neurodevelopmental disability; additional short-term predictors of neurological outcome; potential adverse effects of magnesium sulphate treatment. With the goal of encompassing all relevant outcome data, we will include outcomes measures as defined and reported by individual study authors – for longer-term outcomes, this will include outcomes irrespective of the length of follow up. We will, however, record all such details for transparent reporting purposes, and for possible subgroup and sensitivity analyses, based, for example, on length of follow up. Further, we will not exclude relevant studies that do not report the outcomes of interest of this review; and rather, will summarise the key findings of any such studies in a supplementary file, or similar. Measures of effect See 'Strategy for data synthesis' section below.
- Outcome Measure
- Additional Outcome
- Not applicable.
- Study Method
- Intervention, Meta-analysis, Narrative synthesis, Systematic review
- Keyword
- Female; Humans; Infant, Newborn; Magnesium Sulfate; Neuroprotection; Obstetric Labor, Premature; Premature Birth
- Contact
- Emily Shepherd. [email protected]
- Organisational Affiliation
- South Australian Health and Medical Research Institute (SAHMRI) Women and Kids.
- Funding Source
- Emily Shepherd is funded by an NHMRC Investigator Grant. Grant number(s) <span style=font-size: 14px>State the funder, grant or award number and the date of award</span> 2007800.
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- Australia
- Review Stage
- Review Ongoing
- First Submission Date
- 2022-07-14
- Registration Date
- 2022-07-25
- Anticipated Start Date
- 2022-08-01
- Anticipated Completion Date
- 2022-12-31
- Title Cn
- 新生儿硫酸镁用于神经保护：系统评价
- Title En
- Neonatal magnesium sulphate for neuroprotection: a systematic review.
- Bilingual Status
- complete