背景:综合目前关于干预措施以改善早产儿生存结局的证据对于告知计划和政策至关重要。这项研究的目的是研究局部润肤油应用对早产儿体重的影响。
方法:对随机对照试验(RCTs)进行系统评价和荟萃分析。为了确定相关研究,在多个数据库中进行了全面的搜索,包括PubMed,科克伦,Scopus,临床试验,ProQuestCentral,认识论,和灰色文献来源。纳入标准基于PICO(人口,干预,比较,和结果)格式。使用Cochrane偏倚风险工具进行随机试验(RoB2.0)评估研究质量。使用StataCropMPV.17软件进行数据分析,其中包括评估异质性,进行亚组分析,敏感性分析,和元回归。调查结果是根据PRISMA清单报告的,审查在PROSPERO(CRD42023413770)注册。
结果:在最初的2734篇文章中,共有18项研究纳入1454例早产新生儿的最终分析.这些研究中有14项提供了有助于计算早产新生儿平均体重增加的汇总差异的数据。随机效应荟萃分析显示,平均体重增加有52.15克的显着合并差异(95%CI:45.96,58.35),尽管具有高异质性(I2>93.24%,p0.000)。进行了亚组分析,显示,每天接受向日葵油或椰子油按摩三次的早产儿在体重增加方面表现出更大的平均差异。Meta回归分析表明,润肤油的类型,治疗持续时间,应用频率对观察到的异质性有显著贡献。进行了敏感性分析,不包括两项离群值研究,导致合并平均体重差异为78.57克(95%CI:52.46,104.68)。在九项报告不良事件的研究中,在干预组中,只有2例提到的皮疹和意外滑脱。
结论:现有证据表明,早产儿局部应用润肤油可能会有效促进体重增加,具有中等到高度的确定性。基于这些发现,建议当地政策制定者和卫生规划人员优先考虑在早产儿的新生儿护理中常规使用润肤油。通过将润肤油纳入标准护理方案,医疗保健提供者可以提供额外的支持,以促进早产儿的最佳生长和发育。
BACKGROUND: Synthesizing current evidence on interventions to improve survival outcomes in preterm infants is crucial for informing programs and policies. The objective of this study is to investigate the impact of topical emollient oil application on the weight of preterm infants.
METHODS: A systematic
review and meta-analysis of randomized controlled trials (RCTs) was conducted. To identify relevant studies, comprehensive searches were conducted across multiple databases, including PubMed, Cochrane, Scopus, Clinical trials, ProQuest Central, Epistemonikos, and gray literature sources. The inclusion criteria were based on the PICO (Population, Intervention, Comparison, and Outcomes) format. Study quality was assessed using the Cochrane risk of bias tool for randomized trials (RoB 2.0). Data analysis was performed using StataCrop MP V.17 software, which included evaluating heterogeneity, conducting subgroup analysis, sensitivity analysis, and meta-regression. The findings were reported in accordance with the PRISMA checklist, and the
review was registered with PROSPERO (CRD42023413770).
RESULTS: Out of the initial pool of 2734 articles, a total of 18 studies involving 1454 preterm neonates were included in the final analysis. Fourteen of these studies provided data that contributed to the calculation of the pooled difference in mean weight gain in preterm neonates. The random effects meta-analysis revealed a significant pooled difference in mean weight gain of 52.15 grams (95% CI: 45.96, 58.35), albeit with high heterogeneity (I2 > 93.24%, p 0.000). Subgroup analyses were conducted, revealing that preterm infants who received massages three times daily with either sunflower oil or coconut oil exhibited greater mean differences in weight gain. Meta-regression analysis indicated that the type of emollient oil, duration of therapy, and frequency of application significantly contributed to the observed heterogeneity. A sensitivity analysis was performed, excluding two outlier studies, resulting in a pooled mean weight difference of 78.57grams (95% CI: 52.46, 104.68). Among the nine studies that reported adverse events, only two mentioned occurrences of rash and accidental slippage in the intervention groups.
CONCLUSIONS: The available evidence suggests that the application of topical emollient oil in preterm neonates is likely to be effective in promoting weight gain, with a moderate-to-high level of certainty. Based on these findings, it is recommended that local policymakers and health planners prioritize the routine use of emollient oils in newborn care for preterm infants. By incorporating emollient oils into standard care protocols, healthcare providers can provide additional support to promote optimal growth and development in preterm infants.