Cochrane · systematic review · CD013278
Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants
Mitra, S, Scrivens, A, von Kursell, AM, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
NeonatalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
16
current version
GRADE rated
16
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 12.5%Low 8 · 50%Moderate 6 · 37.5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Early treatment compared to expectant management for preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality during hospital stay Early treatment vs expectant management | RR 0.8 [0.46, 1.39] | 6 studies · 500 participants | Moderate Downgraded: imprecision |
Proportion of infants requiring surgical PDA ligation or transcatheter occlusion Early treatment vs expectant management | RR 1.08 [0.65, 1.8] | 4 studies · 432 participants | Very low Downgraded: imprecision |
Proportion of infants receiving any pharmacotherapy for a hemodynamically significant PDA Early treatment vs expectant management | RR 2.3 [1.86, 2.83] | 2 studies · 232 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Chronic lung disease Early treatment vs expectant management | RR 0.9 [0.62, 1.29] | 4 studies · 339 participants | Moderate Downgraded: imprecision |
Severe Intraventricular hemorrhage (grades III and IV) Early treatment vs expectant management | RR 0.83 [0.32, 2.16] | 2 studies · 171 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Necrotizing enterocolitis (NEC; stage 2 or greater) Early treatment vs expectant management | RR 2.34 [0.86, 6.41] | 5 studies · 473 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Very early treatment compared to expectant management for preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality during hospital stay Very early treatment vs expectant management | RR 0.94 [0.58, 1.53] | 7 studies · 384 participants | Moderate Downgraded: imprecision |
Proportion of infants requiring surgical PDA ligation or transcatheter occlusion Very early treatment vs expectant management | RR 0.88 [0.36, 2.17] | 5 studies · 293 participants | Moderate Downgraded: imprecision |
Proportion of infants receiving any pharmacotherapy for a hemodynamically significant PDA Very early treatment vs expectant management | RR 1.64 [1.31, 2.05] | 4 studies · 156 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Chronic lung disease Very early treatment vs expectant management | RR 0.83 [0.63, 1.08] | 7 studies · 384 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Severe Intraventricular hemorrhage (grades III and IV) Very early treatment vs expectant management | RR 0.64 [0.21, 1.93] | 4 studies · 240 participants | Moderate Downgraded: imprecision |
Necrotizing enterocolitis (NEC; stage 2 or greater) Very early treatment vs expectant management | RR 1.08 [0.53, 2.21] | 5 studies · 332 participants | Moderate Downgraded: imprecision |
Duration of hospitalization Very early treatment vs expectant management | no estimate extracted | 4 studies · 240 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Neurodevelopmental outcomes (moderate/severe cognitive delay at 18 to 24 months) Very early treatment vs expectant management | RR 0.27 [0.03, 2.31] | 1 study · 79 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Neurodevelopmental outcomes (moderate/severe motor delay at 18 to 24 months) Very early treatment vs expectant management | RR 0.54 [0.05, 5.71] | 1 study · 79 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Neurodevelopmental outcomes (moderate/severe language delay at 18 to 24 months) Very early treatment vs expectant management | RR 0.54 [0.1, 2.78] | 1 study · 79 participants | Low Downgraded: risk of bias, imprecision, inconsistency |