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All Journal International Journal of Health, Engineering and Technology
Delta Iswara
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Agriculture, Biological Sciences & Forestry Chemical Engineering, Chemistry & Bioengineering Dentistry Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Mechanical Engineering Medicine & Pharmacology Nursing Public Health Veterinary

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Inotrope Use and the Risk of Intraventricular Hemorrhage in Preterm Neonates: A Systematic Review and Meta Analysis Anggita Dian Karera; Delta Iswara; Amanah Sekar Kinasih; Dyah Ati Sayuka; Din Alfina
International Journal of Health Engineering and Technology Vol. 4 No. 4 (2025): IJHET NOVEMBER 2025
Publisher : CV. AFDIFAL MAJU BERKAH

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Abstract

More than 40% of neonatal hypotension cases are managed with inotropes; however, recent evidence indicates that inotrope administration, rather than hypotension itself, is independently associated with an increased risk of intraventricular hemorrhage (IVH) after adjustment for confounding factors. This systematic review and meta-analysis aimed to evaluate the association between inotrope use and the occurrence of IVH among preterm neonates. The study followed PRISMA guidelines. A systematic literature search was conducted through PubMed, Scopus, ScienceDirect, and Google Scholar. The methodological quality of each study was assessed using the Newcastle-Ottawa Scale (NOS) for case-control and cohort designs. Relevant data were extracted for qualitative and quantitative synthesis. Meta-analysis was performed using a random-effects model based on adjusted odds ratios (aORs) reported in each study, and the results were presented as pooled aORs with 95% confidence intervals. Eight studies met the inclusion criteria. The meta-analysis showed that inotrope use was significantly associated with a higher risk of IVH in preterm neonates, including IVH of any grade (pooled OR 2.03, 95% CI 1.25-3.29) and severe IVH (pooled OR 2.00, 95% CI 1.33-3.02). Overall, inotrope use doubled the risk of IVH (pooled OR 2.00, 95% CI 1.48-2.70). These findings emphasize the need for cautious and strictly indicated inotrope administration along with standardized hemodynamic management.
Neonatal Dengue: A Case Series of Three Patients with a Wide Clinical Spectrum Anggita Dian Karera; Hana Amelia; Delta Iswara; Din Alfina
International Journal of Health Engineering and Technology Vol. 4 No. 4 (2025): IJHET NOVEMBER 2025
Publisher : CV. AFDIFAL MAJU BERKAH

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Neonatal dengue is an uncommon but clinically important condition that can present with a wide range of symptoms. This report describes three neonatal dengue cases with distinct clinical manifestations and emphasizes the importance of early recognition. The objective of this case series is to outline the clinical features, laboratory findings, and treatment outcomes of the affected neonates. All three patients presented with fever accompanied by various symptoms, including seizures, jaundice, respiratory distress, and significant thrombocytopenia. Diagnostic evaluation consisted of serological testing, hematological assessment, and imaging studies when needed. The lowest platelet counts ranged from 10,000 to 14,000 per microliter, although none of the neonates experienced major bleeding or shock. All patients received supportive treatment, including fluid management, monitoring, and therapy tailored to presenting symptoms. Each neonate demonstrated gradual improvement and was discharged in stable condition following appropriate observation. These cases highlight that neonatal dengue may resemble sepsis and thus requires a high level of diagnostic vigilance, particularly in endemic areas or when maternal dengue is suspected. Early serological testing in both mother and infant is valuable for timely diagnosis. Supportive care and close monitoring contribute significantly to preventing complications and achieving favorable outcomes.
Co-Authors Amanah Sekar Kinasih Anggita Dian Karera Din Alfina Dyah Ati Sayuka Hana Amelia