Meta-analysis of the risk factors for intracranial hemorrhage in premature infants / 临床儿科杂志

ABSTRACT

Objective To evaluate the risk factors for intracranial hemorrhage in premature infants. Methods Cochrane Library, PubMed, ScienceDirect, Chinese Academic Literature Main Database, Chinese Science and Technology Periodi-cal Database, Wanfang Periodicals and Dissertation Database were searched for articles published from January 2000 to December 2012 on the risk factors of intracranial hemorrhage in premature infants, with retrospective retrieval and manual retrieval as supplement. RavMan5.2 provided by Cochrane was used for meta-analysis. Fixed-or random-effects models were selected according to the results of heterogeneity test. Results Nine studies were conifrmed to be eligible. Odds ratio (OR) and 95%conifdence interval (CI) of the risk factors were as followsgestation age≤32 weeks (OR=3.29, 95%CI=2.76-3.91), birth weight≤1 500g (OR=2.68, 95% CI=2.24-3.20), maternal complications (OR=1.59, 95% CI=1.23-2.06), intrauterine distress or birth asphyxia (OR=2.42, 95% CI=2.06-2.84), mechanical ventilation (OR=3.23, 95% CI=2.55-4.09), metabolic acidosis (OR=2.88, 95%CI=2.04-4.05), use of high concentration of oxygen (OR=2.98, 95%CI=1.63-5.44), prenatal use of dexametha-sone (OR=0.69, 95%CI=0.55-0.86), respiratory distress syndrome (OR=1.57, 95%CI=1.04-2.39). Those differences were all statistically signiifcant. There was no difference in caesarean section (OR=0.99, 95%CI=0.84-1.17), multiparity (OR=1.05, 95%CI=0.79-1.40) and gender (OR=1.25, 95%CI=0.97-1.59). Conclusions The risk factors for intracranial hemorrhage in premature infants are gestation age≤32 weeks, birth weight≤1 500 g, maternal complications, intrauterine distress or birth asphyxia, mechanical ventilation, metabolic acidosis, use of high concentration of oxygen, respiratory distress syndrome, but prenatal use of dexamethasone can reduce the incidence of intracranial hemorrhage in premature infants.