Phenobarbitone for Prevention and Treatment of Unconjugated Hyperbilirubinemia in Preterm Neonates: A Systematic Review and Meta-analysis.
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Date
2010-05
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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 meta-analysis.
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 meta-analysis. 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.
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Keywords
Neonate, Jaundice, Phenobarbitone, Preterm, Prevention
Citation
Chawla Deepak, Parmar Veena. Phenobarbitone for Prevention and Treatment of Unconjugated Hyperbilirubinemia in Preterm Neonates: A Systematic Review and Meta-analysis. Indian Pediatrics. 2010 May; 47(5): 401-407.