Focal small bowel perforation: an adverse effect of early postnatal dexamethasone therapy in extremely low birth weight infants

J Perinatol. Apr-May 2001;21(3):156-60. doi: 10.1038/sj.jp.7200520.

Abstract

Objective: We tested the hypothesis that early postnatal dexamethasone (EPD) increases the risk of focal small bowel perforation (FSBP) in extremely low birth weight (ELBW) infants.

Study design: The techniques of meta-analysis were applied to studies evaluating EPD, which we identified through a systematic literature search. Studies were included if they were randomized, placebo-controlled trials of EPD, enrolled infants with birth weights < or =1000 g, and reported FSBP as an outcome variable. The Breslow-Day test was used to assess for homogeneity and a summary odds ratio was calculated using the Mantel-Haenszel exact method.

Results: Four studies, with a pooled sample of 1383 infants, were included in the primary analysis. The Breslow-Day test showed a p-value of 0.61, indicating homogeneity among the studies. FSBP was significantly higher in EPD treated infants [odds ratio 1.91, 95% confidence interval (CI) 1.21, 3.07; p=0.004].

Conclusion: EPD increases the risk of FSBP in ELBW infants.

Publication types

  • Meta-Analysis

MeSH terms

  • Anti-Inflammatory Agents / adverse effects*
  • Dexamethasone / adverse effects*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Intestinal Perforation / chemically induced*
  • Intestine, Small
  • Male
  • Odds Ratio
  • Randomized Controlled Trials as Topic

Substances

  • Anti-Inflammatory Agents
  • Dexamethasone