Abstract
Objective: Bronchopulmonary dysplasia (BPD) is one of the major challenges in preterm infants despite the therapeutic improvement. Airway administration of budesonide might be a safe and effective way. However, the optimal timing of airway administration is under determined. The meta-analysis was designed to evaluate the effectiveness and safety of early (≤1d after birth) and late (>1d after birth) airway administration of budesonide in decreasing the incidence of BPD and death as the primary outcome . Methods: PubMed, EMBASE, the Cochrane Library, China national knowledge internet (CNKI), China biology medicine disc (CBM), WANFANG data, and China Science and Technology Journal Database were searched for RCTs that compared airway administration of budesonide with controls. The meta-analysis was performed using Review Manager 5.3. Results: Airway administration of budesonide decreased the risk of BPD at 36 weeks PMA and the composite outcome of BPD or death (RR=0.64, 95%CI: 0.55~0.75 and RR=0.71, 95%CI: 0.57~0.89).Moreover, 37% and 36% reduction was observed in the incidence of BPD and the composite outcome of BPD or death in the early airway administration group (≤1d) (RR=0.63, 95%CI: 0.53~0.75 and RR=0.64, 95%CI: 0.47~0.87 ), while no difference was found in late airway administration group (>1d) (RR=0.74, 95%CI: 0.49~1.13 and RR=0.88, 95%CI: 0.64~1.21). Conclusion: early airway administration (≤1d) of budesonide reduced the incidence of BPD alone or composite outcome of death or BPD, and it is safe without increasing death as well as other short-term side effects. However, because of the small number of infants in late airway administration group and lacking of long-term follow-up, more randomized controlled trials are needed to testify for the outcomes. Keywords: Budesonide, bronchopulmonary dysplasia, premature infants, meta-analysis, airway administration.
Systematic review of the healthcare cost of bronchopulmonary dysplasia
