METAANALYSIS OF PHENOBARBITAL USAGE FOR PREVENTION OF INTRAVENTRICULAR HEMORRHAGE IN PREMATURE-INFANTS - FACTORS RELATED TO VARIATION IN OUTCOME

Purpose: To assess the efficacy of phenobarbital for the prevention of intraventricular hemorrhage (IVH) in premature infants and to identify study characteristics that were associated with beneficial or adverse effects. Data identification: Studies published from 1981 to 1994 were identified through a computerized search, and by searching the bibliographies of all identified articles. Study selection: Ten randomized, controlled clinical trials were selected. Data extraction: Data were extracted from each article, including the percentage of patients in the control and treatment groups with IVH, and key patient and study characteristics. Results of data analysis: Seven studies showed no statistically significant effects, two studies showed a beneficial effect of phenobarbital, and one study showed an adverse effect. The meta-analysis showed no significant difference in the percentage of IVH in treated and untreated infants when treatment effects were combined across all studies. However, prenatal administration of phenobarbital in two studies was associated with a beneficial effect. Conclusions: Overall, we did not find a significant beneficial effect of postnatal phenobarbital administration. The data suggests that prenatal phenobarbital is beneficial. Further evaluations of the efficacy of prenatal phenobarbital are warranted.