Evidence · Systematic review or meta-analysis
Interventions to Reduce Severe Brain Injury Risk in Preterm Neonates: A Systematic Review and Meta-analysis.
- Cord management
- Delivery room and stabilisation
- Intraventricular haemorrhage and white matter injury
- Mechanical ventilation
- Medical
- Neurology
- Patent ductus arteriosus
- Preterm stabilisation
- Respiratory
Summary
This systematic review and meta-analysis of 221 randomised trials evaluated 44 antenatal, delivery room and neonatal interventions for reducing severe intraventricular haemorrhage and cystic periventricular leukomalacia in preterm neonates. Antenatal corticosteroids and indomethacin prophylaxis were associated with reduced severe IVH risk with moderate certainty, while volume-targeted ventilation, early erythropoiesis-stimulating agents and prophylactic ethamsylate showed reductions with low certainty. Umbilical cord milking was associated with increased severe IVH risk compared with delayed cord clamping. The authors urge clinicians to weigh certainty of evidence and applicability before changing practice.
Summary written for NICUlearn. Always read the original.
- Licence:
- Open (Creative Commons)
The full text of this openly licensed paper is available to NICUlearn members, and Neeky can answer questions from it.
Guidelines are shown for education. Follow your unit's own guidance and senior advice.