Meta-analysis Of Vitamin A In Prevention Of Bronchopulmonary Dysplasia In Preterm Infants

Objective:To systematically evaluate the effectiveness and practical significance of vitamin A in preventing and treating bronchopulmonary dysplasia(BPD)in preterm infants.Methods:(1)To collect vitamin A for prevention and treatment of preterm infant BPD in PubMed,China Journal Full-text Database(CNKI),Embase,Weipu,Medline,Wanfang Medical Net and other medical search databases from Building library to August 2017.Data from clinical randomized controlled trials(RCT)and quasi-randomized controlled trials between treatment and placebo or placebo.(2)Data were extracted from two independent individuals and mutual check,and the risk of bias was assessed for the included studies.(3)Perform system analysis using Revman 5.3 software,and use linear fixed-effect models for systematic analysis of continuous results.Results:The meta-analysis showed that there were 1285 cases in 8 studies,of which 649 were in the experimental group and 636 were in the control group.Meta-analysis showed that the early use of vitamin A in preterm infants was beneficial in reducing the incidence of BPD at 36 weeks of gestational age(RR = 0.86,95%,CI: 0.76 to 0.97,P = 0.01);however,the mortality rate for BPD(RR=0.88,95% CI: 0.68 to 1.12,P=0.30)and other related complications such as sepsis(RR=0.88,95% CI: 0.75 to 1.03,P=0.12),retinopathy of prematurity(ROP)(RR=0.81,95% CI: 0.65 to 1.01,P=0.06),severe intraventricular hemorrhage(IVH)(RR=0.91,95% CI: 0.73 to 1.14,P=0.42),necrotizing enterocolitis(NEC)The risk of RR(RR=0.92,95% CI: 0.67 to 1.27,P=0.61)did not decrease significantly.Conclusion: For preterm infants,vitamin A can be recommended to prevent BPD.Early vitamin A supplementation in preterm infants does not reduce BPD mortality,and theincidence of sepsis,retinopathy of prematurity,severe intraventricular hemorrhage,and necrotizing enterocolitis may reduce the incidence of BPD at 36 weeks of gestational age.