Meta-analysis of phenobarbital usage for prevention of intraventricular hemorrhage in premature infants: factors related to variation in outcome.
OBJECTIVE
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.


METHODS
Studies published from 1981 to 1994 were identified through a computerized search, and by searching the bibliographies of all identified articles.


METHODS
Ten randomized, controlled clinical trials were selected.


METHODS
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
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.
Department of Pharmacy, Loyola University Medical Center, Maywood, IL 60153, USA.
D A
DA
Tholl
T Q
TQ
Miller
W G
WG
Henderson
T F
TF
Myers
D001724:Birth Weight; D002543:Cerebral Hemorrhage / Q000517:prevention & control*; D002552:Cerebral Ventricles; D004311:Double-Blind Method; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D008431:Maternal-Fetal Exchange; D016017:Odds Ratio; D010634:Phenobarbital / Q000008:administration & dosage / Q000627:therapeutic use*; D010919:Placebos; D011030:Pneumothorax / Q000209:etiology; D011175:Positive-Pressure Respiration; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome