What do systematic reviews say?

Early treatment vs expectant management

Early treatment showed no clear difference in all‐cause mortality during hospital stay compared with expectant management (moderate certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.8 [0.46, 1.39]
  6 studies · 500 participants
  Moderate

Early treatment vs expectant management

It is very uncertain whether early treatment changes proportion of infants requiring surgical PDA ligation or… compared with expectant management (very low certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 1.08 [0.65, 1.8]
  4 studies · 432 participants
  Very low

Early treatment vs expectant management

Early treatment may leads to higher proportion of infants receiving any pharmacotherapy for a… compared with expectant management (low certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 2.3 [1.86, 2.83]
  2 studies · 232 participants
  Low

Early treatment vs expectant management

Early treatment showed no clear difference in chronic lung disease compared with expectant management (moderate certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.9 [0.62, 1.29]
  4 studies · 339 participants
  Moderate

Early treatment vs expectant management

Early treatment showed no clear difference in severe Intraventricular hemorrhage (grades III and IV) compared with expectant management (low certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.83 [0.32, 2.16]
  2 studies · 171 participants
  Low

Early treatment vs expectant management

Early treatment showed no clear difference in necrotizing enterocolitis (NEC; stage 2 or greater) compared with expectant management (low certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 2.34 [0.86, 6.41]
  5 studies · 473 participants
  Low

Very early treatment vs expectant management

Very early treatment showed no clear difference in chronic lung disease compared with expectant management (low certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.83 [0.63, 1.08]
  7 studies · 384 participants
  Low

Very early treatment vs expectant management

Very early treatment showed no clear difference in severe Intraventricular hemorrhage (grades III and IV) compared with expectant management (moderate certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.64 [0.21, 1.93]
  4 studies · 240 participants
  Moderate

Very early treatment vs expectant management

Very early treatment showed no clear difference in necrotizing enterocolitis (NEC; stage 2 or greater) compared with expectant management (moderate certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 1.08 [0.53, 2.21]
  5 studies · 332 participants
  Moderate

Very early treatment vs expectant management

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 240 participants
  Low

Very early treatment vs expectant management

Very early treatment showed no clear difference in neurodevelopmental outcomes (moderate/severe cognitive delay at 18… compared with expectant management (low certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.27 [0.03, 2.31]
  1 study · 79 participants
  Low

Very early treatment vs expectant management

Very early treatment showed no clear difference in neurodevelopmental outcomes (moderate/severe motor delay at 18 to 24… compared with expectant management (low certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.54 [0.05, 5.71]
  1 study · 79 participants
  Low

Very early treatment vs expectant management

Very early treatment showed no clear difference in neurodevelopmental outcomes (moderate/severe language delay at 18 to… compared with expectant management (low certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.54 [0.1, 2.78]
  1 study · 79 participants
  Low

Very early treatment vs expectant management

Very early treatment showed no clear difference in all‐cause mortality during hospital stay compared with expectant management (moderate certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.94 [0.58, 1.53]
  7 studies · 384 participants
  Moderate

Very early treatment vs expectant management

Very early treatment showed no clear difference in proportion of infants requiring surgical PDA ligation or… compared with expectant management (moderate certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 0.88 [0.36, 2.17]
  5 studies · 293 participants
  Moderate

Very early treatment vs expectant management

It is very uncertain whether very early treatment changes proportion of infants receiving any pharmacotherapy for a… compared with expectant management (very low certainty).

• Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants 2020 · Cochrane Headline outcomes only
  RR 1.64 [1.31, 2.05]
  4 studies · 156 participants
  Very low

Sunlight (with or without filters or amplification) vs no treatment

The review found no eligible studies for this question.

• Sunlight for the prevention and treatment of hyperbilirubinemia in term and late preterm neonates 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Sunlight (with or without filters or amplification) vs other sources of phototherapy

The review found no eligible studies for this question.

• Sunlight for the prevention and treatment of hyperbilirubinemia in term and late preterm neonates 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Early vs late continuous positive airway pressure (CPAP)

The review found no eligible studies for this question.

• Early versus delayed continuous positive airway pressure (CPAP) for respiratory distress in preterm infants 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Prophylactic or very early CPAP vs supportive care

It is very uncertain whether prophylactic or very early CPAP changes failed treatment defined as recurrent apnoea, hypoxia, hypercarbia… compared with supportive care (very low certainty).

• Prophylactic or very early initiation of continuous positive airway pressure (CPAP) for preterm infants 2021 · Cochrane Headline outcomes only
  RR 0.6 [0.49, 0.74]
  4 studies · 765 participants
  Very low