J K H Sinn1, M C Ward, D J Henderson-Smart. 1. Westmead Hospital and Centre for Perinatal Health Services Research, University of Sydney, New South Wales, Australia. johnsinn@westgate.wh.usyd.edu.au
Abstract
OBJECTIVES: To review neuro-developmental outcome at 1 and 2 years of age following randomized controlled trials (RCT) of neonatal surfactant therapy. METHODS: A systematic review of the MEDLINE, Embase and Cochrane Controlled Trial Register databases, searching for RCT of surfactant replacement therapy with follow-up outcomes, was carried out. The main outcome measures were severe and mild disability at 1 and 2 years plus composite adverse outcome of death and/or severe disability. RESULTS: A meta-analysis using odds ratios was carried out on 13 RCT. There were a total of 2218 treated and 2090 control infants who underwent follow up at 1 year of age. There were 303 treated and 292 control infants with follow up at between 18 months and 2 years of age. Surfactant therapy was associated with a lower rate of mild disability at 1 year (OR 0.79; 95% CI 0.66-0.95). There was a reduction in the combined adverse outcome (death or severe disability rate) at 1 year (OR 0.8; 95% CI 0.72-0.89). Neither the 1 year nor the 2 year follow-up examination showed a statistical difference in the severe disability rate between the control and treated group. CONCLUSION: Surfactant therapy increases survival without an increase in subsequent morbidity at 1 and 2 years of age.
OBJECTIVES: To review neuro-developmental outcome at 1 and 2 years of age following randomized controlled trials (RCT) of neonatal surfactant therapy. METHODS: A systematic review of the MEDLINE, Embase and Cochrane Controlled Trial Register databases, searching for RCT of surfactant replacement therapy with follow-up outcomes, was carried out. The main outcome measures were severe and mild disability at 1 and 2 years plus composite adverse outcome of death and/or severe disability. RESULTS: A meta-analysis using odds ratios was carried out on 13 RCT. There were a total of 2218 treated and 2090 control infants who underwent follow up at 1 year of age. There were 303 treated and 292 control infants with follow up at between 18 months and 2 years of age. Surfactant therapy was associated with a lower rate of mild disability at 1 year (OR 0.79; 95% CI 0.66-0.95). There was a reduction in the combined adverse outcome (death or severe disability rate) at 1 year (OR 0.8; 95% CI 0.72-0.89). Neither the 1 year nor the 2 year follow-up examination showed a statistical difference in the severe disability rate between the control and treated group. CONCLUSION: Surfactant therapy increases survival without an increase in subsequent morbidity at 1 and 2 years of age.
Authors: Yvonne E Vaucher; Myriam Peralta-Carcelen; Neil N Finer; Waldemar A Carlo; Marie G Gantz; Michele C Walsh; Abbot R Laptook; Bradley A Yoder; Roger G Faix; Abhik Das; Kurt Schibler; Wade Rich; Nancy S Newman; Betty R Vohr; Kimberly Yolton; Roy J Heyne; Deanne E Wilson-Costello; Patricia W Evans; Ricki F Goldstein; Michael J Acarregui; Ira Adams-Chapman; Athina Pappas; Susan R Hintz; Brenda Poindexter; Anna M Dusick; Elisabeth C McGowan; Richard A Ehrenkranz; Anna Bodnar; Charles R Bauer; Janell Fuller; T Michael O'Shea; Gary J Myers; Rosemary D Higgins Journal: N Engl J Med Date: 2012-12-27 Impact factor: 91.245
Authors: Katinka P Bach; Carl A Kuschel; Stuart B Hooper; Jean Bertram; Sue McKnight; Shirley E Peachey; Valerie A Zahra; Sharon J Flecknoe; Mark H Oliver; Megan J Wallace; Frank H Bloomfield Journal: PLoS One Date: 2012-10-08 Impact factor: 3.240