Neuroprotective Effects of Quercetin in Neonatal Hypoxic-Ischemic Brain Injury: A Meta-analysis.

Abstract

This study assesses the neuroprotective potential of quercetin in preclinical models of neonatal hypoxic-ischemic brain injury (HIBI) and its role as a possible enhancer of therapeutic hypothermia.A systematic review of 8 preclinical studies was conducted per PRISMA guidelines, sourced from PubMed, Scopus, and Web of Science, with a random-effects meta-analysis.Quercetin significantly lowered infarct volume, seizure susceptibility, and inflammation (pooled standardized mean differences [SMD]&#x2009;=&#x2009;1.29; 95% confidence interval [CI]: 1.00-1.58;&#x2009;<&#x2009;0.001). Higher doses (>30&#x2009;mg/kg, SMD&#x2009;=&#x2009;1.65) and intraperitoneal (IP) administration (SMD&#x2009;=&#x2009;1.42) outperformed lower doses or intravenous (IV) routes (SMD&#x2009;=&#x2009;0.95). Rat models showed greater benefits (SMD&#x2009;=&#x2009;1.38) than piglets (SMD&#x2009;=&#x2009;0.85). Moderate heterogeneity (&#x2009;=&#x2009;45%) was noted, but sensitivity analysis confirmed robustness (SMD&#x2009;=&#x2009;1.20). Publication bias was minimal (&#x2009;=&#x2009;0.12).Quercetin offers notable neuroprotection in neonatal HIBI, with an optimal 40&#x2009;mg/kg IP dose, suggesting it could complement hypothermia. Limited bioavailability and lack of long-term data call for further research in advanced models. &#xb7; Quercetin improves outcomes in neonatal HIBI.. &#xb7; IP route shows greater efficacy.. &#xb7; Higher doses (>30&#x2009;mg/kg) are more effective.. &#xb7; Meta-analysis confirms significant benefit (SMD&#x2009;=&#x2009;1.29).. &#xb7; Bioavailability remains a key translational barrier..