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Oral propranolol in prevention of severe retinopathy of prematurity: a systematic review and meta-analysis

Journal of Perinatology volume 39, pages 1584–1594 (2019)Cite this article

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A Correction to this article was published on 29 October 2019

This article has been updated

Abstract

Objective

To systematically assess the efficacy of oral beta blockage treatment in primary (before established) and secondary (in threshold stages) prevention of severe retinopathy of prematurity (ROP) in premature infants born ≤32 weeks gestational age.

Study design

Following the PRISMA guidelines, published literature was systematically assessed up to April 27, 2018. Trials and observational studies, in which beta blockage was used to prevent severe ROP (defined as stage ≥3, or requiring treatment) were included. Meta-analyses including random effects models were conducted to determine the overall effect of oral beta blockage on prevention of ROP.

Results

Six studies (five clinical trials and one observational study) including 461 infants met inclusion criteria using propranolol. The pooled relative risk (RR) of severe ROP in the primary and secondary prophylaxis groups were 0.65 (95% CI 0.43–0.98, NNT = 7) and 0.48 (95% CI 0.35–0.65, NNT = 6) in RCTs, respectively. The RR of severe ROP in one observational study was 0.21 (95% CI 0.08–0.55) with a NNT of 3. There were low heterogeneity and publication bias. Side effects occurred in 8.4% of participants on propranolol.

Conclusions

Systematic assessment of studies showed that prophylactic oral propranolol appeared to be effective in preventing severe ROP in premature infants ≤32 weeks gestational age. Additional well powered, multinational, randomized control trials reporting on long-term outcomes are needed.

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Change history

  • 29 October 2019

    An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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Acknowledgements

We would like to thank Dr Aldo Bancalari, Dr Filippi, Dr Sanghvi, and Dr Makhoul for providing extra data through email and phone conversations on their respective studies.

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Authors and Affiliations

  1. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    A. Stritzke & A. Lodha

  2. Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB, Canada

    A. Stritzke & A. Lodha

  3. Libin Cardiovascular Institute of Alberta, University of Calgary, AB, Canada

    A. Stritzke

  4. Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India

    N. Kabra

  5. Department of Pediatrics, McMaster University, Hamilton, ON, Canada

    S. Kaur

  6. Liaison Librarian, Clinical Medicine, Health Sciences Library, University of Calgary, Calgary, AB, Canada

    H. L. Robertson

  7. Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada

    A. Lodha

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  1. A. Stritzke
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  2. N. Kabra
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  3. S. Kaur
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Correspondence to A. Stritzke.

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These finding were presented in an oral presentation at the Pediatric Academic Society Meeting 2018 in Toronto, and as poster presentation at the District VIII American Academy of Pediatrics Meeting 2018 in Utah.

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Stritzke, A., Kabra, N., Kaur, S. et al. Oral propranolol in prevention of severe retinopathy of prematurity: a systematic review and meta-analysis. J Perinatol 39, 1584–1594 (2019). https://doi.org/10.1038/s41372-019-0503-x

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