Deepak Chawla1, Veena Parmar. 1. Department of Pediatrics, Government Medical College Hospital, Chandigarh, India. drdeepakchawla@hotmail.com
Abstract
OBJECTIVE: To evaluate the role of phenobarbitone in the management of unconjugated hyperbilirubinemia during first two weeks of life in preterm neonates. DESIGN: Meta-analysis. METHODS: A study was eligible for inclusion in the metaanalysis if it randomized preterm neonates into control and treatment groups. Standard search strategy of the Cochrane Neonatal Review Group was used. For categorical and continuous data the odds ratio (OR) and weighted mean difference (WMD) were calculated, respectively. 95% confidence intervals were used and a fixed effects model was assumed for the metaanalysis. MAIN OUTCOME MEASURES: Peak serum bilirubin, duration of phototherapy, need of phototherapy and exchange transfusion, neurodevelopmental outcome and adverse effects. RESULTS: A total of 19 potentially relevant studies were identified. Of these, 3 studies (497 neonates) were included in the metaanalysis. Peak serum bilirubin was significantly lower in phenobarbitone group (mean difference: -1.78 mg/dL, 95% CI: -2.29 to -1.27). Duration of phototherapy was shorter (mean difference: -14.75 h, 95% CI: -26.67 to -2.83). Need of phototherapy (OR: 0.33, 95% CI: 0.13 to 0.81) and exchange transfusion (OR: 0.30, 95% CI: 0.14 to 0.64) were also reduced in phenobarbitone group. CONCLUSION: Phenobarbitone reduces peak serum bilirubin, duration and need of phototherapy and need of exchange transfusion in preterm very low birthweight neonates. Further studies are warranted to evaluate adverse effects and neurodevelopmental outcome.
OBJECTIVE: To evaluate the role of phenobarbitone in the management of unconjugated hyperbilirubinemia during first two weeks of life in preterm neonates. DESIGN: Meta-analysis. METHODS: A study was eligible for inclusion in the metaanalysis if it randomized preterm neonates into control and treatment groups. Standard search strategy of the Cochrane Neonatal Review Group was used. For categorical and continuous data the odds ratio (OR) and weighted mean difference (WMD) were calculated, respectively. 95% confidence intervals were used and a fixed effects model was assumed for the metaanalysis. MAIN OUTCOME MEASURES: Peak serum bilirubin, duration of phototherapy, need of phototherapy and exchange transfusion, neurodevelopmental outcome and adverse effects. RESULTS: A total of 19 potentially relevant studies were identified. Of these, 3 studies (497 neonates) were included in the metaanalysis. Peak serum bilirubin was significantly lower in phenobarbitone group (mean difference: -1.78 mg/dL, 95% CI: -2.29 to -1.27). Duration of phototherapy was shorter (mean difference: -14.75 h, 95% CI: -26.67 to -2.83). Need of phototherapy (OR: 0.33, 95% CI: 0.13 to 0.81) and exchange transfusion (OR: 0.30, 95% CI: 0.14 to 0.64) were also reduced in phenobarbitone group. CONCLUSION:Phenobarbitone reduces peak serum bilirubin, duration and need of phototherapy and need of exchange transfusion in preterm very low birthweight neonates. Further studies are warranted to evaluate adverse effects and neurodevelopmental outcome.
Authors: Laurent M A Favié; Floris Groenendaal; Marcel P H van den Broek; Carin M A Rademaker; Timo R de Haan; Henrica L M van Straaten; Peter H Dijk; Arno van Heijst; Sinno H P Simons; Koen P Dijkman; Monique Rijken; Inge A Zonnenberg; Filip Cools; Alexandra Zecic; Johanna H van der Lee; Debbie H G M Nuytemans; Frank van Bel; Toine C G Egberts; Alwin D R Huitema Journal: Neonatology Date: 2019-06-28 Impact factor: 4.035
Authors: Mahmoud Af Kaabneh; Ghassan Sa Salama; Ayoub Ga Shakkoury; Ibrahim Mh Al-Abdallah; Afrah Alshamari; Ruba Aa Halaseh Journal: Clin Med Insights Pediatr Date: 2015-08-09