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Therapeutic hypothermia for neonates with hypoxic-ischaemic encephalopathy in low- and lower-middle-income countries: a systematic review and meta-analysis.

Authors :
Prakash, Raj
Reyes-García, Diana Verónica
Hansoge, Sanjana Somanath
Rosenkrantz, Ted S
Source :
Journal of Tropical Pediatrics. Oct2024, Vol. 70 Issue 5, p1-18. 18p.
Publication Year :
2024

Abstract

Hypoxic-ischaemic encephalopathy (HIE) is a major cause of mortality and neurodevelopmental disability, especially in low-income countries. While therapeutic hypothermia has been shown to reduce morbidity and mortality in infants with HIE, some clinical trials in low-income countries have reported an increase in the risk of mortality. We conducted a systematic review and meta-analysis of all randomized and quasi-randomized controlled trials conducted in low-income and lower-middle-income countries that compared cooling therapy with standard care for HIE. Our primary outcome was composite of neonatal mortality and neurodevelopmental disability at 6 months or beyond. The review was registered with PROSPERO (CRD42022352728). Our review included 11 randomized controlled trials with 1324 infants with HIE. The composite of death or disability at 6 months or beyond was lower in therapeutic hypothermia group (RR 0.78, 95% CI 0.66–0.92, I 2 = 85%). Neonatal mortality rate did not differ significantly between cooling therapy and standard care (RR 0.92, 95% CI 0.76–1.13, I 2 = 61%). Additionally, the cooled group exhibited significantly lower rates of neurodevelopmental disability at or beyond 6 months (RR 0.34, 95%CI 0.22–0.52, I 2 = 0%). Our analysis found that neonatal mortality rate did not differ between cooled and noncooled infants in low- and lower-middle-income countries. Cooling may have a beneficial effect on neurodevelopmental disability and the composite of death or disability at 6 months or beyond. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01426338
Volume :
70
Issue :
5
Database :
Academic Search Index
Journal :
Journal of Tropical Pediatrics
Publication Type :
Academic Journal
Accession number :
180119847
Full Text :
https://doi.org/10.1093/tropej/fmae019