Continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborns at birth: A systematic review
Background: Respiratory distress is common during transition after birth, but the effect of continuous positive airway pressure applied in the delivery room has not been systematically evaluated in spontaneously breathing term and ≥34+0 weeks’ gestation infants.We aimed to compare delivery room cont...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520422001205 |
| _version_ | 1797980383060426752 |
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| author | Birju A. Shah Jorge G. Fabres Tina A. Leone Georg M. Schmölzer Edgardo G. Szyld |
| author_facet | Birju A. Shah Jorge G. Fabres Tina A. Leone Georg M. Schmölzer Edgardo G. Szyld |
| author_sort | Birju A. Shah |
| collection | DOAJ |
| description | Background: Respiratory distress is common during transition after birth, but the effect of continuous positive airway pressure applied in the delivery room has not been systematically evaluated in spontaneously breathing term and ≥34+0 weeks’ gestation infants.We aimed to compare delivery room continuous positive airway pressure with no delivery room continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborn infants at birth. Methods: Information sources: Medline, Embase, Cochrane Databases, Database of Abstracts of Reviews of Effects, and Cumulative Index to Nursing and Allied Health Literature. The Databases were last searched in October 2021.Eligibility criteria: Randomized, quasi-randomized, interrupted time series, controlled before-after, and cohort studies with English abstracts.Synthesis of results: Two authors independently extracted data, assessed risk of bias, and certainty of evidence. The main outcome was admission to the neonatal intensive care unit (NICU) or higher level of care receiving any positive pressure support. Data were pooled using fixed effects models.Risk of bias: Was assessed using the Cochrane Risk of Bias Tool for randomized trials and the Non-Randomized Studies of Interventions Tool (ROBINS-I) for observational studies. Results: In this meta-analysis, two randomized control trials (323 newborns delivered by cesarean section) showed that delivery room continuous positive airway pressure decreased the likelihood of NICU admission (risk ratio (RR) 95% confidence interval (CI) 0.27 (0.11–0.66), p < 0.005) and NICU respiratory support (RR (95% CI) 0.18 (0.05–0.60), p = 0.005) when compared with no delivery room continuous positive airway pressure. However, in two before-after studies (8,476 newborns), delivery room continuous positive airway pressure use was associated with an increased risk of air leak syndrome when compared with no delivery room continuous positive airway pressure. Discussion: Certainty of evidence was very low for all outcomes. Among term and ≥34+0 weeks’ gestation infants having or at risk of having respiratory distress, there is insufficient evidence to suggest for or against routine use of continuous positive airway pressure in the delivery room.Funding: No Funding has been received to conduct this study.Clinical Trial Registration: This systematic review has been registered with the International Prospective Register of Systematic Reviews (http://www.crd.york.ac.uk/prospero/) [identifier: CRD42021225812]. |
| first_indexed | 2024-04-11T05:53:15Z |
| format | Article |
| id | doaj.art-97ecebd377d74ae5a58c05f4116cb078 |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-04-11T05:53:15Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-97ecebd377d74ae5a58c05f4116cb0782022-12-22T04:41:59ZengElsevierResuscitation Plus2666-52042022-12-0112100320Continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborns at birth: A systematic reviewBirju A. Shah0Jorge G. Fabres1Tina A. Leone2Georg M. Schmölzer3Edgardo G. Szyld4Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Corresponding author at: Section of Neonatal-Perinatal Medicine, Oklahoma Children’s Hospital at the University of Oklahoma (OU) Health, 1200 Children's Ave, ETNP #7504, Oklahoma City, OK 73104, United States.Department of Neonatology, School of Medicine, Pontificia Universidad Católica de Chile, ChileColumbia University Vagelos College of Physicians and Surgeons, New York City, NY, United StatesUniversity of Alberta, CanadaDepartment of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United StatesBackground: Respiratory distress is common during transition after birth, but the effect of continuous positive airway pressure applied in the delivery room has not been systematically evaluated in spontaneously breathing term and ≥34+0 weeks’ gestation infants.We aimed to compare delivery room continuous positive airway pressure with no delivery room continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborn infants at birth. Methods: Information sources: Medline, Embase, Cochrane Databases, Database of Abstracts of Reviews of Effects, and Cumulative Index to Nursing and Allied Health Literature. The Databases were last searched in October 2021.Eligibility criteria: Randomized, quasi-randomized, interrupted time series, controlled before-after, and cohort studies with English abstracts.Synthesis of results: Two authors independently extracted data, assessed risk of bias, and certainty of evidence. The main outcome was admission to the neonatal intensive care unit (NICU) or higher level of care receiving any positive pressure support. Data were pooled using fixed effects models.Risk of bias: Was assessed using the Cochrane Risk of Bias Tool for randomized trials and the Non-Randomized Studies of Interventions Tool (ROBINS-I) for observational studies. Results: In this meta-analysis, two randomized control trials (323 newborns delivered by cesarean section) showed that delivery room continuous positive airway pressure decreased the likelihood of NICU admission (risk ratio (RR) 95% confidence interval (CI) 0.27 (0.11–0.66), p < 0.005) and NICU respiratory support (RR (95% CI) 0.18 (0.05–0.60), p = 0.005) when compared with no delivery room continuous positive airway pressure. However, in two before-after studies (8,476 newborns), delivery room continuous positive airway pressure use was associated with an increased risk of air leak syndrome when compared with no delivery room continuous positive airway pressure. Discussion: Certainty of evidence was very low for all outcomes. Among term and ≥34+0 weeks’ gestation infants having or at risk of having respiratory distress, there is insufficient evidence to suggest for or against routine use of continuous positive airway pressure in the delivery room.Funding: No Funding has been received to conduct this study.Clinical Trial Registration: This systematic review has been registered with the International Prospective Register of Systematic Reviews (http://www.crd.york.ac.uk/prospero/) [identifier: CRD42021225812].http://www.sciencedirect.com/science/article/pii/S2666520422001205Transition after birthSpontaneously breathingTermLate pretermInfant neonatesStabilization |
| spellingShingle | Birju A. Shah Jorge G. Fabres Tina A. Leone Georg M. Schmölzer Edgardo G. Szyld Continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborns at birth: A systematic review Resuscitation Plus Transition after birth Spontaneously breathing Term Late preterm Infant neonates Stabilization |
| title | Continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborns at birth: A systematic review |
| title_full | Continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborns at birth: A systematic review |
| title_fullStr | Continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborns at birth: A systematic review |
| title_full_unstemmed | Continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborns at birth: A systematic review |
| title_short | Continuous positive airway pressure for term and ≥34+0 weeks’ gestation newborns at birth: A systematic review |
| title_sort | continuous positive airway pressure for term and ≥34 0 weeks gestation newborns at birth a systematic review |
| topic | Transition after birth Spontaneously breathing Term Late preterm Infant neonates Stabilization |
| url | http://www.sciencedirect.com/science/article/pii/S2666520422001205 |
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