Mortality rates during hospitalisation and calculated risk ratios
| Intervention | Control | Author (year) | Mortality outcome intervention, n (%) | Mortality outcome control, n (%) | RR | 95% CI | P value | GRADE quality of evidence |
| Feeding interventions | ||||||||
| 3-hour feeding schedule | 2-hour feeding schedule | Tali et al67 (2016) | 0 | 0 | NA | NA | NA | ⨁⨁◯◯ Low* |
| Infection prevention | ||||||||
| rhG-CSF | Empirical antibiotics alone | Aktas et al48 (2015) | 10 (30.3) | 6 (26.1) | 1.16 | 0.49–2.74 | 0.73 | ⨁⨁◯◯ Low* |
| Synbiotics | Standard care | Nandhini et al62 (2016) | 10 (9.3) | 9 (8.2) | 1.13 | 0.48–2.68 | 0.78 | ⨁⨁◯◯ Low* |
| Lactobacillus sporogenes | Breast milk or formula alone | Sari et al64 (2011) | 3 (2.7) | 4 (3.6) | 0.76 | 0.17–3.30 | 0.71 | ⨁⨁◯◯ Low* |
| Prevention and treatment of respiratory morbidity | ||||||||
| Nasal-jet CPAP | Bubble CPAP | Bhatti et al52 (2015) | 20 (25) | 16 (18) | 1.41 | 0.78–2.52 | 0.25 | ⨁⨁⨁◯ Moderate† |
| Bubble CPAP | Flow driver CPAP | Mazmanyan et al60 (2016) | 3 (4.5) | 1 (1.7) | 2.68 | 0.29–25.08 | 0.39 | ⨁⨁◯◯ Low*‡ |
| Preintervention period | Okello et al63 (2019) | 58 (26.5) | 62 (39.2) | 0.68 | 0.50–0.91 | 0.01 | ⨁⨁◯◯ Low§ | |
| VLBW 36 (19.7) | 41 (31.5) | 0.62 | 0.42–0.92 | 0.02 | ⨁⨁◯◯ Low§ | |||
| ELBW 22 (61.1) | 21 (75) | 0.82 | 0.58–1.14 | 0.23 | ⨁◯◯◯ Very low†§ | |||
| Ventilator-derived CPAP | Tagare et al66 (2013) | 4 (7) | 5 (8.8) | 0.80 | 0.23–2.83 | 0.73 | ⨁⨁◯◯ Low* | |
| Binasal prong | Nasal mask for applying nasal CPAP | Say et al65 (2016) | 4 (5.4) | 7 (9.3) | 0.56 | 0.17–1.85 | 0.34 | ⨁⨁◯◯ Low* |
Surfactant
| Beractant | Gharehbaghi et al54 (2010) | 21 (26.6) | 15 (21.1) | 1.26 | 0.70–2.25 | 0.44 | ⨁⨁⨁◯ Moderate† |
| Conventional INSURE method | Halim et al56 (2018) | 19 (38) | 28 (56) | 0.68 | 0.44–1.04 | 0.08 | ⨁⨁⨁◯ Moderate† |
| Beractant | Jain et al57 (2019) | 21 (40.4) | 14 (30.4) | 1.33 | 0.77–2.30 | 0.31 | ⨁⨁⨁◯ Moderate† |
| Vitamin A supplementation | Placebo | Basu et al51 (2019) | 9 (9.2) | 16 (16.3) | 0.56 | 0.26–1.21 | 0.14 | ⨁⨁⨁◯ Moderate† |
| Pulse oximetry | Preintervention period | Graham et al55 (2019) | 82 (13.4) | 326 (17.4) | 1.12 | 0.56–2.26¶ | 0.76¶ | ⨁⨁⨁◯ Moderate† |
| Full O2 system | Preintervention period | 203 (19.5) | 326 (17.4) | 0.99¶ | 0.61–1.59¶ | 0.96¶ | ⨁⨁⨁◯ Moderate† | |
| Volume-guaranteed ventilation | Pressure-controlled ventilation | Krishna et al58 (2019) | 4 (10) | 5 (12.2) | 0.82 | 0.24–2.84 | 0.75 | ⨁⨁◯◯ Low* |
| Aminophylline | Caffeine | Kumar et al59 (2017) | 16 (21.9) | 15 (21.4) | 1.02 | 0.55–1.91 | 0.94 | ⨁⨁◯◯ Low†** |
| High flow nasal cannula | Nasal CPAP | Murki et al61 (2018) | 4 (3.0) | 3 (2.1) | 1.39 | 0.32–6.11 | 0.66 | ⨁⨁◯◯ Low* |
| Strategies of newborn care | ||||||||
| Maternal nursing care | Special care baby unit | Arif et al49 (1999) | 43 (28.5) | 141 (66.8) | 0.43 | 0.33–0.56 | 0·0000 | ⨁⨁⨁◯ Moderate** |
| Stepdown unit | Preintervention period | Bhutta et al53 (2004) | 55 (17.3) | 63 (33) | 0.52 | 0.38–0.72 | 0·0001 | ⨁⨁⨁◯ Moderate§ |
| Others | ||||||||
| Oral paracetamol for PDA closure | Oral ibuprofen | Balachander et al50 (2018) | 12 (21.8) | 11 (20) | 1.10 | 0.53–2.26 | 0.81 | ⨁⨁◯◯ Low* |
| Polythene tobacco wrap | Standard nursing procedure | Van Den Bosch et al68 (1996) | 0 | 6 (54.5) | 0.06 | 0·0036–0.93 | 0.04 | ⨁⨁◯◯ Low†** |
*Insufficient sample to meet optimal information size (OIS) criteria with very few events and 95% CI fails to exclude important benefit or harm.
†Insufficient sample to meet OIS criteria and/or 95% CI close to or crosses line of no effect or fails to exclude important benefit or harm.
‡Derived from the meta-analysis pooling the results of both studies.
§Serious risk of selection bias.
¶Mixed-model odds ratio; accounted for the clustering of patients within hospitals and adjusted for time trends.
**Substantial loss to follow-up in relation to the number of events and failure to adhere to the intention-to-treat principle.