Asset Details
Do you wish to reserve the book?
Early erythropoietin for preventing necrotizing enterocolitis in preterm neonates — an updated meta-analysis
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
Early erythropoietin for preventing necrotizing enterocolitis in preterm neonates — an updated meta-analysis
Do you wish to request the book?
Early erythropoietin for preventing necrotizing enterocolitis in preterm neonates — an updated meta-analysis
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
Early erythropoietin for preventing necrotizing enterocolitis in preterm neonates — an updated meta-analysis
2022
Overview
Previous systematic reviews suggest reduction in necrotizing enterocolitis (NEC) among preterm infants supplemented with erythropoietin (EPO). We aimed to update our 2018 systematic review in this field considering the evidence accumulated over the last 3 years. Randomized controlled trials (RCTs) reporting the effect of early EPO supplementation vs placebo/no EPO supplementation on any stage NEC in preterm infants were included. Fixed effect model was used for meta-analysis. Trial sequential analysis (TSA) was conducted to verify the effects of EPO on NEC after accounting for repeated significance testing. A total of 22 RCTs (
n
= 5359) were included, of which six were new (
n
= 2541 additional preterm infants) in comparison to our previous systematic review. EPO significantly decreased the risk of
any stage
NEC (232/2669 (8.7%) vs 313/2690 (11.6%); RR: 0·76; TSA adjusted 95% CI (0·64, 0·90);
p
= 0·0008, number needed to treat (NNT) = 34). The risk of
definite
NEC (≥ Stage II) was also significantly reduced by EPO administration (105/2219 (4.7%) vs 141/2246 (6.3%); RR: 0.77; 95% CI (0.61, 0.98);
p
= 0.03, NNT: 62). However, the results for
definite
NEC were no longer significant on sensitivity analyses that included (a) only double-blind RCTs and (b) only prospectively registered trials. The quality of evidence was deemed moderate-to-low for the reported outcomes.
Conclusion
: There is moderate to low-quality evidence that early prophylactic EPO reduces
any stage
and ≥ Stage II NEC in preterm neonates. Prospectively registered, adequately powered, double-blind RCTs are required to confirm these findings.
What is Known:
• Experimental studies have shown that erythropoietin (EPO) has gastrointestinal trophic effects.
• Systematic reviews have shown that early treatment with EPO may decrease the risk of gut injury in preterm or low birth weight infants.
What is New:
• Early EPO supplementation significantly reduced the incidence of any stage NEC and definite NEC in preterm infants < 34 weeks of gestation.
• EPO had no significant effect on definite NEC in the analyses that included only double-blinded and prospectively registered RCTs.
How might it impact clinical practice in the foreseeable future?
• Early prophylactic EPO can be recommended for NEC prevention if its benefits are consistently demonstrated in adequately powered randomized trials with a low risk of bias.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
