Journal of neonatal-perinatal medicine最新文献

{"title":"Exploring the role of glycemic variability in the development of treatment-requiring retinopathy of prematurity.","authors":"Radhika Maddali, C Zhang, U Mian, M Kim, T Havranek","doi":"10.1177/19345798251359897","DOIUrl":"https://doi.org/10.1177/19345798251359897","url":null,"abstract":"<p><p>BackgroundGlycemic variability is a common complication affecting very preterm infants. Hypoglycemia and hyperglycemia have been associated with increased neonatal morbidities, including retinopathy of prematurity (ROP). However, it remains unclear whether glycemic variability contributes to a higher risk of ROP. Our study investigated the relationship between glycemic variability and severe, treatment-requiring ROP in preterm infants during the first 28 days of life.MethodsA retrospective case-control study was conducted on infants with a birthweight ≤1500 g and/or gestational age ≤30 weeks. Cases included infants with severe ROP requiring treatment (<i>n</i> = 31) and were matched to controls with no ROP or ROP not requiring treatment (<i>n</i> = 62) in a 1:2 ratio. Glycemic variability was quantified as the standard deviation of mean glucose levels. Statistical analysis included t-tests, chi-squared, and Fisher's tests, with logistic regression models to adjust for confounders.ResultsDemographics and clinical variables were similar in cases and controls except for ethnicity and PDA. The mean glucose concentration was 130.74 mg/dl (±39.98) in the treatment group and 121.26 mg/dl (±47.44) in controls (<i>p</i> = 0.32). The number of hypo and hyperglycemic episodes was not significantly different between the two groups. Glycemic variability was also similar in cases and controls (mean SD = 36.01 vs 33.45, respectively; <i>p</i> = 0.31). After adjusting for confounders, no association was found between glycemic variability and ROP treatment.ConclusionOur study did not identify a significant association between glycemic variability and the development of severe, treatment-requiring ROP.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251359897"},"PeriodicalIF":0.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DCC-ET-Caesar: Feasibility and safety of delayed cord clamping with ex-utero transfusion in elective caesarean deliveries - A pilot study.","authors":"Nireesha Bukke, Mishu Mangla, Sivam Thanigainathan, Anusha Devalla, Naina Kumar, Annapurna Srirambhatla, Nabnita Patnaik","doi":"10.1177/19345798251360768","DOIUrl":"https://doi.org/10.1177/19345798251360768","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BackgroundDelayed cord clamping (DCC) and placental transfusion techniques have been associated with improved neonatal outcomes, including enhanced haemodynamic stability and increased haemoglobin levels. Physiological cord clamping (PCC) also ensures a smoother cardiovascular transition at birth by maintaining placental circulation until the neonate establishes independent respiration. However, the optimal timing for clamping in cases of delayed cord clamping remains unclear. This pilot study aims to evaluate the feasibility and safety of delayed cord clamping with ex-utero transfusion (DCC-ET), after Doppler-confirmed cessation of umbilical blood flow in elective caesarean deliveries.MethodsA prospective, single-arm pilot feasibility study was conducted on women undergoing elective caesarean sections at term. The DCC technique used in this study, delayed cord clamping with ex-utero transfusion (DCC-ET), is a modification of the methods previously described in literature. Following delivery, the uterine incision was inspected, and bleeding points were secured without urgency to clamp the cord. The placenta was allowed to separate spontaneously and was removed with controlled cord traction. The newborn remained attached to the placenta, which was elevated approximately 30 cm above the baby to facilitate ex-utero transfusion. Cord clamping was performed only after complete cessation of umbilical blood flow, confirmed by Doppler assessment at a fixed point 10 cm from the cord insertion. Maternal-neonatal outcomes, including Apgar scores, haemoglobin levels, neonatal intensive care unit admissions, maternal blood loss, and any adverse events, were recorded.ResultsA total of 40 women were included. The DCC-ET procedure was successfully completed in all cases. The mean time to umbilical cord blood flow cessation, and umbilical cord clamping was 6.60 ± 1.91 minutes post-delivery. Compared to the 1-minute DCC group, maternal blood loss was significantly lower, and postoperative haemoglobin drop was less in the DCC-ET group. Residual placental blood volume was markedly reduced (11.40 ± 2.56 mL vs 45.91 ± 13.01 mL; &lt;i&gt;p&lt;/i&gt; = 0.001). Neonatal haematocrit at 48-72 hours was significantly higher in the DCC-ET group (61.25 ± 2.39% vs 55.81 ± 5.41%; &lt;i&gt;p&lt;/i&gt; = 0.001), with no increase in neonatal hypothermia or adverse outcomes. Cord separation occurred earlier in the DCC-ET group. Apgar scores and phototherapy requirements were comparable between groups. No significant postpartum haemorrhage or maternal complications were observed.ConclusionThe present pilot study demonstrates that DCC-ET is a feasible and safe procedure during elective caesarean deliveries. The protocol was successfully implemented in the majority of cases, with no increase in maternal or neonatal complications and acceptable integration into routine clinical practice. Doppler assessment of umbilical blood flow provided a practical method to individualize cord clamping timing, althoug","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251360768"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the appropriate intravitreal ranibizumab dose for retinopathy of prematurity: A systematic review.","authors":"S Salsabila, S A Nabilah, J Jutamulia","doi":"10.1177/19345798251353790","DOIUrl":"https://doi.org/10.1177/19345798251353790","url":null,"abstract":"<p><p>BackgroundDespite the use of laser therapy as the current treatment for retinopathy of prematurity (ROP), the administration of ranibizumab is recognized as a promising alternative treatment for ROP despite the current use of laser therapy. Therefore, this systematic review aimed to systematically analyze the effectiveness of different ranibizumab dosage.MethodsA literature search of PubMed, Cochrane, and ScienceDirect was conducted for studies including infants with ROP, using intravitreal injection of ranibizumab (IVR) as primary monotherapy, and reporting ROP regression and recurrence. All studies were required to be written in English-language and published in the last ten years. The selection process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.ResultsA total of ten studies were reviewed, including three randomized controlled trials, five retrospectives, and two case series. Furthermore, 549 patients and 867 eyes in the treatment group were evaluated, examining various stages of ROP and different therapeutic methods. All studies reported ROP regression, ranging from 68.9% to 100%, while 80% reported ROP recurrence following IVR.ConclusionIntravitreal injections of ranibizumab were effective in improving ROP outcomes. Meanwhile, lower doses of IVR provided comparable therapeutic benefits to the higher dose, potentially with fewer side effects.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251353790"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing neonatal outcomes of positive- versus negative-pressure extubation: A randomized trial.","authors":"S Nourolahi, P Solimani, A Direkvand-Moghadam","doi":"10.1177/19345798251330807","DOIUrl":"10.1177/19345798251330807","url":null,"abstract":"<p><p>BackgroundNeonatal respiratory distress is a major issue for many infants. When non-invasive ventilation fails, endotracheal intubation is often used to secure the airway. However, extubation moving from mechanical ventilation to spontaneous breathing also has its challenges and risks.ObjectiveThis randomized controlled trial aimed to compare neonatal outcomes between positive- and negative-pressure extubation methods in a cohort of neonates ready for extubation.MethodsThis randomized controlled trial was conducted at Ayatollah Taleghani Hospital in Ilam, Iran, from May 2021 to March 2023; the study enrolled 101 neonates, who were divided into three groups: positive pressure, negative pressure, and self-extubation. Neonates with congenital respiratory defects, meconium aspiration, and bacterial pneumonia were excluded from the study. The primary outcomes assessed included the duration of intubation, need for oxygen post-extubation, and length of hospitalization. Statistical analysis was performed using the independent-samples Kruskal-Wallis test, with a significance level set at <i>p</i> < 0.05.ResultsNo statistically significant differences were found in the duration of intubation (<i>p</i> = 0.436), need for oxygen after extubation (<i>p</i> = 0.785), and length of hospitalization (<i>p</i> = 0.357) among the groups. There was a significant difference in the duration of intubation, need for oxygen after extubation, and length of hospital stay based on gestational age at birth (<i>p</i> = 0.000). However, there was no significant correlation between age at birth and re-intubation (<i>p</i> = 0.297).ConclusionThere are no significant differences in key outcomes like intubation duration, post-extubation oxygen needs, and hospitalization length, suggesting that the choice of extubation method may not greatly affect these factors.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"304-311"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The comparison of placental findings and pregnancy outcomes before and during COVID-19 pandemic.","authors":"Helen Y How, Mureena A Turnquest-Wells, Michael W Daniels, Christina L Waldon","doi":"10.1177/19345798251330831","DOIUrl":"10.1177/19345798251330831","url":null,"abstract":"<p><p>BackgroundThe impact of SARS-CoV-2 on pregnancy outcomes is unclear, but evidence suggests increased perinatal loss due to placental damage and fetal oxygen deprivation.ObjectiveThis study compared placental findings and fetal outcomes between pre-COVID-19 and COVID-19 periods to assess the association between COVID-19 and abnormal placental pathology and fetal complications. It was hypothesized that COVID-19-positive pregnancies would have higher rates of intrauterine fetal demise and fetal growth restriction due to virus-induced placental injury.Study DesignA retrospective analysis of 34,102 deliveries compared placental and fetal outcomes across two periods: pre-COVID-19 (April 1, 2018-September 30, 2019) and COVID-19 (April 1, 2020-September 30, 2021), with a washout period in between. Placental abnormalities (chorangiosis, chorioamnionitis, and villitis) and fetal outcomes (fetal growth restriction and intrauterine fetal demise) were analyzed using chi-squared tests with odds ratios (ORs) and 95% confidence intervals (CIs).ResultsThe COVID-19 period showed a significant increase in placental findings: chorangiosis, chorioamnionitis, villitis, and fetal growth restriction. Placentas from COVID-19-positive mothers had higher rates of these findings, though the increase in fetal growth restriction was not statistically significant. Intrauterine fetal demise rates were higher in COVID-19-negative pregnancies but did not differ between periods.ConclusionRoutine antenatal fetal testing for COVID-19 positivity alone is not warranted. We agree a follow-up fetal growth ultrasound 4 weeks post-infection is advisable per Society for Maternal-Fetal Medicine guidelines. The role of maternal comorbidities in chorangiosis remains unclear, warranting further investigation.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"338-343"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To retrospectively study the use of antibiotics among neonates with a gestational age of ≥ 35 weeks experiencing respiratory distress, and to identify the risk factors associated with antibiotic use.","authors":"Sarfrazul Abedin, Khalil Mohd Khalil Salameh, Lina Hussain M Habboub, Sajid Thyvilayil Salim, Samer Mahmoud Alhoyed, Brijroy Viswanathan, Rajai Rofail Raja Al-Bedaywi, Hoda Eljelani Rahoma, Esam Mohamed Elhadi Elhaji, Anvar Paraparambil Vellamgot","doi":"10.1177/19345798251339652","DOIUrl":"10.1177/19345798251339652","url":null,"abstract":"<p><p>BackgroundRespiratory distress is a common reason for NICU admission among late preterm and term neonates. Antibiotic use is prevalent among these neonates requiring respiratory support. This study investigates antibiotic use and its associated risk factors.MethodsA retrospective study was conducted at Al Wakra Hospital, Qatar, from January to December 2022. Neonates born at 35 weeks gestation or more, admitted to the NICU with respiratory distress, and requiring respiratory support were included based on specific criteria.ResultsOf the 1194 neonates admitted to the NICU, 1062 were 35 weeks or more gestational age. Among these, 485 neonates developed respiratory distress requiring respiratory support, with 442 included in the final analysis. Antibiotics were used in 56.1% (248/442) of cases. Factors such as maternal age, parity, rupture of membranes, chorioamnionitis, group B streptococci, antenatal prophylactic antibiotics, mode of delivery, sex, fetal distress, meconium-stained amniotic fluid, need for resuscitation, Apgar score ≤7 at 5 minutes, age at NICU admission, duration of NICU admission, maximum respiratory support, and duration of respiratory support were significantly associated with antibiotic use. Regression analysis identified parity, gestational age, sex, meconium-stained amniotic fluid, and duration of respiratory support as significant predictors of antibiotic use.ConclusionsRespiratory distress leads to frequent NICU admissions among late preterm and term neonates, with 56.1% receiving antibiotics. To mitigate potential harm from antibiotic exposure, strategies to reduce use without increasing neonatal sepsis risk are essential.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"377-385"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of morphine in the development of neonatal cholestasis in extremely preterm neonates.","authors":"A H Abdelwahab, L O Abdullah, N Mohammed, Mrp Alikunju, P V Abdul Rouf, B Thomas, B Sree, W M Elkassem","doi":"10.1177/19345798251336731","DOIUrl":"10.1177/19345798251336731","url":null,"abstract":"<p><p>BackgroundMorphine is commonly used in ventilated neonates as an analgesic with many side effects like respiratory depression and hypotension. Only a few studies have investigated morphine's influence on biliary tract dynamics. Therefore, we planned this study to find out the relationship between morphine and liver function in preterm neonates.MethodsThis retrospective study was conducted at the Women's Wellness and Research Centre by reviewing the case records of neonates admitted between 01^st January 2015 and 31^st December 2020. Preterm infants on mechanical ventilation, between gestational ages (GA) ≥24 and ≤37 weeks, were included in the study. Participants were divided into two groups according to morphine use, and liver function test values were compared, including direct (DB), total bilirubin (TB), alanine transaminase (ALT), and aspartate transaminase (AST).ResultsThe study comprised 133 preterm newborns; out of them, 73 received morphine (Group A) and 60 did not receive it (Group B). The mean GA was 29.90 ± 5.18 weeks, and birth weight was 1250 ± 418 grams. At admission, DB levels were higher in group B than in group A (54.71 ± 50.0 vs. 36.77 ± 48.53, <i>p</i> = .038). However, the peak and discharge values were higher in group A than in group B (<i>p</i> = .001 and <i>p</i> = .196, respectively). The peak AST, DB, and TB values were higher in group A.ConclusionThe present study showed the impact of morphine on liver function in preterm neonates and the possibility of morphine hepatotoxicity. Clinicians should use morphine cautiously in preterm neonates to avoid the risk of developing cholestasis and hepatotoxicity.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"350-361"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal level of care and length of stay of moderate and late preterm infants.","authors":"Prashanth Murthy, Amuchou Soraisham, Sarfaraz Momin, Ayman Abou Mehrem, Sumesh Thomas, Nalini Signal, Belal Alshaikh","doi":"10.1177/19345798251339648","DOIUrl":"10.1177/19345798251339648","url":null,"abstract":"<p><p>ObjectiveTo compare the length of hospitalization for moderate and late preterm infants (MLPIs; 32^0/7-36^6/7 weeks gestation) born at tertiary care (level III) perinatal centers versus secondary care perinatal centers (level II).MethodsThis was a retrospective cohort study of all MLPIs born at one of four perinatal centers (one tertiary and three secondary) in Calgary, Canada. All preterm infants born before 36^0/7 were routinely admitted to neonatal intensive care units (NICUs). We excluded infants with major congenital anomalies and those receiving planned palliative care. Multivariable logistic, propensity score-matched, and quantile regression analyses were used to adjust for potential confounding factors.ResultsOf the 1958 infants who met inclusion criteria, 676 (34.5%) infants were born at a tertiary care perinatal center with a level III NICU, and 1284 (65.5%) were born in secondary care perinatal centers with a level II NICU. The average gestational age was 34.8 weeks. Infants born at level II centers had shorter durations of hospital stay (adjusted mean difference [aMD] -1.0 day; 95% CI -1.7, -0.4) and tube feeding (aMD -2.2 day; 95% CI -2.9, -1.4), a lower need for peripheral intravenous access (adjusted odds ratio (aOR) 0.66; 95% CI 0.53, 0.83), reduced use of infant formula during hospitalization (aOR 0.58; 95% CI 0.43, 0.78), and a higher rate of breastmilk feeding at discharge (aOR 1.34; 95% CI 1.01, 1.77).ConclusionDelivery of MLPIs in secondary care perinatal centers is associated with shorter hospital stays and higher breastmilk feeding rates at discharge.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"369-376"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous aspergillosis in a premature infant.","authors":"Prateek Sharma, Tazuddin Mohammed","doi":"10.1177/19345798251330833","DOIUrl":"10.1177/19345798251330833","url":null,"abstract":"<p><p>Fungal infections in preterm infants are uncommon but serious infections that carry a high mortality rate. Preterm infants who are extremely low birth weight are at high risk for fungal infections due to immaturity of their immune system and skin barrier. Factors which further reduce host immunity in premature infants include prolonged use of broad-spectrum antibiotics and corticosteroids. Our case presentation involves an extremely low-weight 23-week preterm infant diagnosed with primary invasive cutaneous aspergillosis (PCA) confirmed by skin biopsy and cultures obtained from skin debridement. His inoculation was thought to be secondary to either a thermal burn or macerated skin from prolonged incubation. This case highlights the importance of keeping fungal infections at the forefront of one's differential diagnosis when an extremely low-weight infant presents with cutaneous lesions, as disseminated fungal infections carry a high mortality rate.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"390-394"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Heated Humidified High Flow Nasal Cannula to Nasal Continuous Positive Airway Pressure as post-extubation respiratory support in preterm infants: A comprehensive systematic review and meta-analysis.","authors":"Amir Mohammad Armanian, Behzad Barekatain, Negin Ghasemi Kahrizsangi, Payam Naseh Ghafoori, Maryam Yazdi, Elaheh Mazaheri, Mina Nekuei","doi":"10.1177/19345798251348160","DOIUrl":"10.1177/19345798251348160","url":null,"abstract":"<p><p>BackgroundThis study aims to compare the efficacy and complications of CPAP with HHHFNC, as post-extubation modalities for respiratory support in neonates.MethodsA comprehensive search was conducted in five electronic databases: MEDLINE (via PUBMED), Scopus, Web of Science, Google Scholar, and Embase in September 2022; screening observational and clinical trial studies for eligibility. Primary outcomes of the study included extubation failure at 72 hours and at 7 days.ResultsNine clinical trials were included, encompassing 1471 infants. Extubation failure at 72 days was more common with HHHFNC although insignificantly (OR = 3.40, 95% CI: 0.87, 13.23), but it was found to be significantly higher at 7 days when opting for HHHFNC (OR = 1.65, 95% CI: 1.02, 2.67). In an overall analysis, extubation failure was significantly higher in infants treated with HHHFNC (OR = 1.61, 95% CI: 1.14, 2.26). Among secondary outcomes, nasal trauma was significantly higher when CPAP was utilized (OR = 0.20 95% CI: 0.10, 0.42). Meta-analysis suggests that there are no differences in the risks for BPD (OR = 1.27, 95% CI: 0.79, 2.06), ROP (OR = 0.88, 95% CI: 0.51, 1.52), NEC (OR = 0.63, 95% CI: 0.41, 0.97), PVL (OR = 0.71, 95% CI: 0.29, 2.96), IVH (OR = 1.04, 95% CI: 0.53, 2.04), and mortality (OR = 0.96, 95% CI: 0.56, 1.66).ConclusionAccording to our review, CPAP remains the choice of non-invasive respiratory support modality regarding its lower risk for extubation failure. Although nasal trauma continues to be a challenging side effect for neonates treated with CPAP, other neonatal complications are equally prevalent when comparing CPAP and HHHFCN.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"287-303"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}