Outcomes of very preterm infants with hyperglycaemia treated with insulin: A systematic review and meta-analysis.
Acta Paediatr
; 112(6): 1157-1164, 2023 06.
Article
em En
| MEDLINE
| ID: mdl-36895111
ABSTRACT
AIM:
To study the outcomes of very preterm infants with hyperglycaemia treated with Insulin.METHODS:
This is a systematic review of randomised controlled trials (RCTs) and observational studies. PubMed, Medline, EMBASE, Cochrane Library, EMCARE and MedNar databases were searched in May 2022. Data were pooled separately for adjusted and unadjusted odds ratios (ORs) using random-effects model. MAIN OUTCOMEMEASURES:
Mortality and morbidities (e.g. Necrotising enterocolitis [NEC], retinopathy of prematurity [ROP]) in very preterm (<32 weeks) or very low birth weight infants (<1500 g) after treatment of hyperglycaemia with insulin.RESULTS:
Sixteen studies with data from 5482 infants were included. Meta-analysis of unadjusted ORs from cohort studies showed that insulin treatment was significantly associated with increased mortality [OR 2.98 CI (1.03 to 8.58)], severe ROP [OR 2.23 CI (1.34 to 3.72)] and NEC [OR 2.19 CI (1.11 to 4)]. However, pooling of adjusted ORs did not show significant associations for any outcomes. The only included RCT found better weight gain in the insulin group, but no effect on mortality or morbidities. Certainty of evidence was 'Low' or 'Very low'.CONCLUSION:
Very low certainty evidence suggests that Insulin therapy may not improve outcomes of very preterm infants with hyperglycaemia.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Retinopatia da Prematuridade
/
Hiperglicemia
/
Doenças do Prematuro
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article