The effects of early vitamin A supplementation on the prevention and treatment of bronchopulmonary dysplasia in premature infants: a systematic review and meta-analysis

Background: Bronchopulmonary dysplasia (BPD) is a common and unique chronic disease of premature infants with a high mortality rate. A large number of studies have shown that vitamin A supplementation has a better effect on the prevention and treatment of BPD. Methods: Randomized controlled trials (RCTs) on early vitamin A supplementation for the prevention and treatment of BPD were searched in PubMed, EMBASE, and the Cochrane Library database. The search time was from the establishment of the database to July 28, 2021. Two investigators performed standard independent screening trials of the literature according to the inclusion and exclusion criteria. The methodology of the included articles was evaluated, and the data were extracted. If the opinions of the 2 investigators were not consistent, a third party could be consulted. The Cochrane systematic review manual was used to analyze the bias of the included studies, and the RevMan 5.3 software was used to perform the meta-analysis. Results: In the experimental group, the BPD incidence [-0.71, 95% confidential interval (CI): -0.34-0.00; Z=1.98; P=0.05], 28-day oxygen uptake rate (0.81, 95% CI: 0.38-1.730; Z=0.53; P=0.59), 36-week survival rate (1.08, 95% CI: 0.80-1.46; Z=0.49; P=0.62), incidence of patent ductus arteriosus (0.77, 95% CI: 0.27-2.21; Z=0.48; P=0.63), days of mechanical ventilation (0.02, 95% CI: -1.46-1.49; Z=0.02; P=0.98), and 28-day ventilator use (0.77, 95% CI: 0.31-1.92; Z=0.55; P=0.58) were lower than those in the control group, especially the incidence of BPD. Discussion: Early supplementation of vitamin A showed good efficacy and safety in the prevention and treatment of BPD in premature infants, and can also improve the survival rate of infants. Therefore, it is worthy of clinical application.