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Am J Perinatol
DOI: 10.1055/a-2578-1875
Original Article

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

Ceren Can 
1   Department of Pediatric Allergy and Immunology, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
,
Şahin Hamilçıkan 
2   Department of Neonatology, University of Health Sciences, Bağcılar Training and Research Hospital, Istanbul, Türkiye
› Author Affiliations
Funding None.
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Abstract

Objective

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.

Study Design

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.

Results

Quercetin significantly lowered infarct volume, seizure susceptibility, and inflammation (pooled standardized mean differences [SMD] = 1.29; 95% confidence interval [CI]: 1.00–1.58; p < 0.001). Higher doses (>30 mg/kg, SMD = 1.65) and intraperitoneal (IP) administration (SMD = 1.42) outperformed lower doses or intravenous (IV) routes (SMD = 0.95). Rat models showed greater benefits (SMD = 1.38) than piglets (SMD = 0.85). Moderate heterogeneity (I 2 = 45%) was noted, but sensitivity analysis confirmed robustness (SMD = 1.20). Publication bias was minimal (p = 0.12).

Conclusion

Quercetin offers notable neuroprotection in neonatal HIBI, with an optimal 40 mg/kg IP dose, suggesting it could complement hypothermia. Limited bioavailability and lack of long-term data call for further research in advanced models.

Key Points

  • Quercetin improves outcomes in neonatal HIBI.

  • IP route shows greater efficacy.

  • Higher doses (>30 mg/kg) are more effective.

  • Meta-analysis confirms significant benefit (SMD = 1.29).

  • Bioavailability remains a key translational barrier.

Keywords

quercetin - neonatal hypoxic-ischemic brain injury - neuroprotection - meta-analysis - therapeutic hypothermia


Publication History

Received: 21 February 2025

Accepted: 08 April 2025

Article published online:
30 April 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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