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Comparative Effectiveness of Prophylactic Therapies for Necrotizing Enterocolitis in Preterm Infants: Protocol for a

Behnam Sadeghirad1,2, Ivan D Florez1,3, Yaping Chang1

  • 1Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada.

International Journal of Preventive Medicine
|October 5, 2018
PubMed

Insights

This study compares therapies to prevent necrotizing enterocolitis (NEC) in premature infants. It aims to provide evidence for optimal NEC prevention strategies, improving infant outcomes.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Evidence-Based Medicine

Background:

  • Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease affecting premature infants, characterized by high morbidity and mortality.
  • Existing research on NEC prevention lacks comprehensive comparisons of available therapies, hindering evidence-based clinical decision-making.
  • Identifying effective preventive strategies is crucial for improving outcomes in vulnerable preterm and low birth weight infants.

Purpose of the Study:

  • To systematically identify and evaluate all eligible trials assessing preventive interventions for necrotizing enterocolitis (NEC) in preterm and/or low birth weight infants.
  • To compare the efficacy and safety of various NEC preventive therapies through conventional and network meta-analyses.
  • To provide a comprehensive overview of evidence for NEC prevention, informing clinical practice and future research.

Main Methods:

  • A systematic literature search will be conducted across multiple databases (MEDLINE, EMBASE, etc.) and grey literature.
  • Eligible studies will include randomized trials in preterm or low birth weight infants comparing preventive interventions to placebo or other interventions.
  • Conventional and network meta-analyses will be performed to assess outcomes including severe NEC, mortality, sepsis, and hospitalization duration, with certainty assessed using GRADE.

Main Results:

  • The study will synthesize data from eligible randomized controlled trials on NEC preventive therapies.
  • Meta-analyses will quantify the relative effects of different interventions on key clinical outcomes.
  • The certainty of evidence for direct, indirect, and network estimates will be rigorously assessed.

Conclusions:

  • This systematic review and meta-analysis will provide a robust comparison of NEC preventive therapies.
  • Findings will address current literature limitations, offering valuable insights for optimizing NEC prevention in clinical settings.
  • The study aims to contribute to improved survival and reduced long-term complications for infants at risk of NEC.

Keywords:
Multiple treatment comparisonnecrotizing enterocolitispreterm infantspreventive therapiessystematic review

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