Abstract:

Objective To review the efficacy of early intratracheal administration of budesonide for preventing bronchopulmonary dysplasia (BPD) in preterm neonates using meta-analysis methods.Methods Related literatures were retrieved in PubMed, EMBASE, the Cohrane Library, CNKI and Wanfang Database from establishment to June 2016. Two reviewers independently screened literatures, extracted data, and assessed the quality of included studies. The meta-analysis was performed by RevMan 5.3 software. A subgroup analysis about delivery method was made between inhalation (subgroup A) and using surfactant as a vehicle (subgroup B). Results Six randomized controlled trials (1 347 infants) with low risk of bias were included in meta-analysis. The analysis showed that the incidence of BPD was decreased in experimental groups, the RR and 95%CI was 0.67(0.57,0.78), and similar trends were found in subgroup A and B, the corresponding RR and 95%CI was 0.74(0.61,0.90) and 0.53(0.40,0.70), respectively. There was no significant difference in mortality between experimental and control groups, the corresponding RR and 95% CI was 0.94(0.60,1.47). However, the incidence of BPD or death was lower in experimental groups, the RR and 95%CI was 0.74(0.60,0.91), and the incidence of BPD or death was lower in subgroup B than that in subgroup A, the corresponding RR and 95%CI was 0.60(0.49,0.74) and 0.87(0.76,1.00), respectively. There was no significant difference in the incidence of infection (sepsis) or retinopathy of prematurity between experimental and control groups.Conclusion The incidence of BPD can be decreased by early intratracheal administration of budesonide, and the delivery method of using surfactant as a vehicle may be better than inhalation.