Neonatology最新文献

{"title":"Ultrasound-Guided Non-Tunneled Centrally Inserted Central Catheters versus Peripherally Inserted Central Catheters in Neonates under 1,000 Grams: A Comparative Cohort Study.","authors":"Antonella Capasso, Fiorentino Grasso, Mario Meliande, Serena Salomè, Letizia Capasso, Francesco Raimondi","doi":"10.1159/000552258","DOIUrl":"10.1159/000552258","url":null,"abstract":"<p><strong>Introduction: </strong>Peripherally inserted central catheters (n-PICCs) are standard in neonatal intensive care but carry high complication rates. Ultrasound-guided non-tunneled centrally inserted central catheters (nT-CICCs) offer a potential alternative. This study compared outcomes of nT-CICCs versus n-PICCs in extremely low birth weight (ELBW) neonates.</p><p><strong>Methods: </strong>This is a single-center, comparative cohort study (April 2022-October 2025) enrolling neonates <1,000 g requiring central venous access. A retrospective cohort receiving n-PICCs was compared with a prospective cohort receiving nT-CICCs. The primary outcome was central line-associated bloodstream infection (CLABSI) density rate on successfully placed catheters. Secondary outcomes included procedural success, mechanical complications, and risk factors for CLABSI.</p><p><strong>Results: </strong>We analyzed 103 catheter insertions (50 nT-CICCs, 53 n-PICCs). Procedural success was 100% for nT-CICCs and 94% for n-PICCs (3 immediate failures excluded from follow-up). Among 100 indwelling catheters, nT-CICCs showed significantly lower CLABSI rates (1.83 vs. 11.09 per 1,000 catheter-days; p = 0.038). Overall complications affected 4% of the nT-CICC group versus 64% of the n-PICC group (p < 0.001). nT-CICCs enabled therapy completion in 66% of cases compared with 12% for n-PICCs. Catheter type was the sole independent predictor of CLABSI (adjusted HR 7.1, 95% CI: 1.01-49.74; p = 0.048).</p><p><strong>Conclusions: </strong>Ultrasound-guided nT-CICCs are associated with significantly lower rates of infectious and mechanical complications compared with n-PICCs in ELBW neonates. This approach provides a safer and more durable option for central venous access in this vulnerable population.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007725","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":"2025 American and European Guidelines on Neonatal Resuscitation: Concordance and Differences.","authors":"Daniele Trevisanuto, Viraraghavan V Ramaswamy, Somashekhar Nimbalkar, Gary M Weiner","doi":"10.1159/000552450","DOIUrl":"10.1159/000552450","url":null,"abstract":"<p><strong>Background: </strong>Neonatal resuscitation guidelines are periodically updated to reflect advances in evidence and clinical practice. In October 2025, the American Heart Association-American Academy of Pediatrics (AHA-AAP) and the European Resuscitation Council (ERC) released updated neonatal resuscitation guidelines, both based on the scientific evaluations of the International Liaison Committee on Resuscitation. Despite this shared foundation, relevant differences remain between the two documents in terms of scope, structure, and specific clinical recommendations.</p><p><strong>Summary: </strong>We reviewed the documents, identified several areas of divergence, and reached a qualitative consensus about their clinical importance. This narrative review compares the 2025 AHA-AAP and ERC guidelines, focusing on algorithm design, initial stabilization, ventilation strategies, and oxygen administration. Both guidelines promote a gentle, physiology-based approach to neonatal transition and emphasize family-centered care. However, they diverge in several areas, including the complexity of resuscitation algorithms, the management of ventilation, and recommendations for initial inspired oxygen concentration. Many of these differences reflect variations in the scope of the documents rather than conflicting interpretations of evidence.</p><p><strong>Key messages: </strong>Several recommendations continue to rely on limited data and reflect a consensus of expert opinion. Persistent gaps in knowledge underscore the need for further high-quality research to inform future updates and support greater harmonization of neonatal resuscitation practices.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trio Whole-Genome Sequencing for Diagnosis of Neonates with Multiple Congenital Anomalies.","authors":"Hyun Ho Kim, Yun Sil Chang, Woong-Yang Park, Joonhong Park","doi":"10.1159/000552497","DOIUrl":"10.1159/000552497","url":null,"abstract":"<p><strong>Introduction: </strong>Genetic disorders are major causes of morbidity and mortality in neonatal intensive care units (NICUs), yet traditional tests like karyotyping and chromosomal microarray (CMA) often fail to provide a diagnosis, resulting in a \"diagnostic odyssey\". Trio whole-genome sequencing (WGS) has emerged as a comprehensive tool capable of detecting a wide range of variants beyond protein-coding regions, potentially offering higher diagnostic yields and rapid, actionable results for critical care management.</p><p><strong>Methods: </strong>This prospective study evaluated 16 neonates with multiple congenital anomalies who had previously received negative results from conventional genetic investigations. Trio WGS was performed using the Illumina NovaSeq 6000 platform, targeting a mean coverage of ×30. A stringent bioinformatics pipeline and a three-step filtering process were applied to prioritize rare functional variants (MAF <0.1%) and genes specifically curated for NICU-associated conditions.</p><p><strong>Results: </strong>A molecular diagnosis was achieved in 37.5% (6/16) of the cases within the first 6 months of age. Pathogenic or likely pathogenic variants were identified in genes including SCN4A, DLL1, ACTA1, KLHL40, CHD7, and CNTNAP1, covering both autosomal recessive and autosomal dominant inheritance patterns. These findings provided definitive diagnoses for complex conditions such as arthrogryposis, congenital myopathy, and CHARGE syndrome.</p><p><strong>Conclusion: </strong>Trio WGS is a highly effective and feasible diagnostic tool for neonates with clinically heterogeneous anomalies, successfully identifying causes where standard-of-care testing fails. Its implementation in the NICU facilitates targeted medical management, informs prognosis, and provides essential data for family planning.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950513","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":"Prolonged Low-Dose Paracetamol Prophylaxis Accelerates Ductal Closure in Extremely Preterm Neonates: A Randomized Trial.","authors":"Tiina Ukkonen, Eveliina Ronkainen, Aliisa Laitala, Timo Saarela, Mikko Hallman, Outi Aikio","doi":"10.1159/000552204","DOIUrl":"10.1159/000552204","url":null,"abstract":"<p><strong>Introduction: </strong>Patent ductus arteriosus (PDA) is associated with increased morbidities and mortality in extremely preterm infants. The biological effect of acetaminophen on the closure of ductus has been shown; however, the effective and safe dosage for early treatment of the most preterm infants remains unknown.</p><p><strong>Methods: </strong>In a single-centre, randomised, controlled, double-blind, phase II pilot trial, extremely low gestational age (ELGA, <28 wk) and/or birth weight (<1,000 g) infants were randomized to intravenous paracetamol or 0.45% saline-placebo. The treatment started before 96 h age, with loading dose of 20 mg/kg and maintenance of 7.5 mg/kg every 6 h for 9 days. Ductal patency was assessed prior to trial initiation and monitored daily, using cardiac ultrasound. Primary outcome was the duration of ductal closure. Secondary outcomes included ductal closure rates, treatment of symptomatic PDA, serum paracetamol levels, long-term morbidities, and mortality.</p><p><strong>Results: </strong>After consent, 40 infants were randomly allocated soon after birth. The intention-to-treat analysis included 39 infants; 19 had paracetamol and 20 placebos. The median (IQR) ductal closure time was 3 (10) days in the paracetamol group, versus 14 (20) days in the placebo group (p = 0.031). Ductus was closed in 15 (75%) vs. 7 (35%) infants, respectively, p = 0.016 (number needed to treat = 3). Three infants in the placebo group received post-study treatment for PDA. The numbers of adverse events were similar in both study groups.</p><p><strong>Conclusion: </strong>Early, 9-day paracetamol administration, compared to placebo, significantly shortened the ductal closure time without increase in adverse events in ELGA infants.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiorespiratory Transitioning at Birth during Varying Levels of Resuscitation and the Role of Dry-Electrode ECG (NeoBeat) and Pulse Oximetry in a Low Resource Setting.","authors":"Emily Ahn, Jackline Cypriane, Ester Ngowi, Aisa Shayo, Jeffrey Perlman","doi":"10.1159/000552554","DOIUrl":"10.1159/000552554","url":null,"abstract":"<p><strong>Introduction: </strong>Studies on neonatal cardiorespiratory transition are important in guiding resuscitation guidelines. The objectives were to determine the immediate transitional changes of heart rate (HR) and saturation values in neonates who received various levels of resuscitation and the level of agreement between NeoBeat and pulse oximetry.</p><p><strong>Methods: </strong>High-risk deliveries (n = 63) in a low resource setting were observed using pulse oximetry and NeoBeat in three groups: comfortably breathing receiving no resuscitation, labored breathing receiving oxygen only, and apneic receiving bag mask ventilation (BMV) plus oxygen. Data were analyzed by time of birth and compared for levels of agreement.</p><p><strong>Results: </strong>Comfortably breathing neonates had initial saturation values (86 ± 13%) with relatively high initial HRs (177 ± 19 beats per minute [bpm]). For neonates receiving oxygen only, 43% reached target saturation goals despite an initial HR of 150 ± 21 bpm, while the BMV group had 73% reach target saturation goals with an initial HR of 88 ± 40 bpm. Bland-Altman revealed low bias in all groups and progressively wider lines of agreement as neonates required more resuscitation. In the BMV group, pulse oximetry often displayed a lower HR than NeoBeat at lower mean HR values.</p><p><strong>Conclusions: </strong>Elevated early saturation values and higher HRs in comfortably breathing neonates may be indicative of a seamless cardiorespiratory adaptation. For neonates requiring resuscitation, oxygen alone without positive end-expiratory pressure may delay respiratory transitioning, as evidenced by low oxygen saturations at 5 min, whereas a higher percentage of neonates receiving BMV with oxygen met target saturation goals.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Mothers' Recollection of the Consistency of Information from Antenatal Consultations with Their Postnatal Experiences.","authors":"Cosima Babinet, Hélène Gauthier-Moulinier, Nicolas Romain-Scelle, Marine Butin","doi":"10.1159/000552256","DOIUrl":"10.1159/000552256","url":null,"abstract":"<p><strong>Introduction: </strong>The primary aim of the study was to assess mothers' perception of the consistency of information retained from antenatal consultations relative to their experience of their neonate's hospitalization. Secondary aims included evaluating the quality of information delivered on fetal status, management, and prognosis, and identifying factors associated with perceived inconsistencies between retained information and experience.</p><p><strong>Methods: </strong>This questionnaire-based study involved the mothers of neonates treated in a tertiary neonatal intensive care unit (Hôpital Femme-Mère-Enfant, Lyon, France). Mothers were included if they had attended a prenatal diagnosis consultation and gave birth between January 2020 and December 2022 to a newborn admitted to the NICU. The main dependent variable was the perceived consistency of information provided during prenatal consultations compared with mothers' experiences of hospitalization. A descriptive statistical analysis was performed, and quantitative variables were summarized as medians and qualitative variables as counts and percentages.</p><p><strong>Results: </strong>Of 106 eligible mothers, 64 (60%) responded to the questionnaire. Among the latter, 68% (43/63) reported that the information received during antenatal consultations was mostly or fully consistent with their experience of their neonate's hospitalization. Among the 20 mothers who reported disparities (32%), 7 (35%) reported inconsistencies with information provided by other specialists and 5 (25%) reported not receiving information on their newborn's condition or prognosis.</p><p><strong>Conclusion: </strong>This study highlights the need to improve the consistency and clarity of information provided during antenatal consultations, particularly in a multidisciplinary context, and to better convey prognostic uncertainties. Further studies are required on the impact of these interventions on maternal experiences, preferably with a prospective design to limit recall bias.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Positioning on Work of Breathing and Oxygenation in Premature Infants at Discharge: A Prospective Observational Study.","authors":"Kelley Kovatis, Amy Mackley, Shannon Traczykiewicz, Tariq Rahman, Thomas H Shaffer","doi":"10.1159/000548619","DOIUrl":"10.1159/000548619","url":null,"abstract":"<p><strong>Introduction: </strong>Premature infants are predisposed to respiratory failure. Body position impacts lung volumes and pulmonary function. Respiratory inductance plethysmography (RIP) measures thoracoabdominal motion and can provide objective, noninvasive diagnostic measurements of work of breathing (WOB) indices. The objective of this study was to compare WOB indices and oxygen saturation in the semi-reclined position to the supine position for preterm infants with and without BPD at discharge.</p><p><strong>Methods: </strong>A prospective, observational study of premature infants (<32 weeks of gestation) admitted to the neonatal intensive care unit. RIP is a noninvasive way to objectively measure WOB indices. Measurements (phase angle [Փ]) were made with infants in the semi-reclined and supine positions.</p><p><strong>Results: </strong>This study included 28 premature infants with both supine and semi-reclined data. Infants demonstrated decreased phase angle (supine vs. semi-reclined Φ deg (standard error of mean [SEM], 65.2 [10.2] vs. 28.5 [5.9], p = 0.027) and LBI (supine vs. semi-reclined, 1.82 [0.27] vs. 1.13 [0.04], p < 0.01) in the semi-reclined position. Saturations were statistically but not clinically lower in the semi-reclined position (supine vs. semi-reclined %, 96.7 [0.4] vs. 95.3 [0.4]). Infants with BPD demonstrated a greater improvement in WOB in the semi-reclined position compared to premature controls.</p><p><strong>Conclusion: </strong>This is the first study to evaluate and compare discharge oxygen saturation and WOB indices in premature infants with and without BPD in the semi-reclined and supine position. Our findings demonstrate improved breathing parameters and a small clinically insignificant decrease in saturations in the semi-reclined position.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"57-63"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491365","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":"Priority Neonatal Interventions Are Powerful: When Rooted in Nurturing Care.","authors":"Arti Maria","doi":"10.1159/000548459","DOIUrl":"10.1159/000548459","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"129-130"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088583","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":"Azithromycin for Prevention of Bronchopulmonary Dysplasia and Other Neonatal Adverse Outcomes in Preterm Infants: An Updated Systematic Review and Meta-Analysis.","authors":"Meghna Joseph, Mrinal Murali Krishna, Vanessa Karlinski Vizentin, Henrique Provinciatto, Chidubem Ezenna","doi":"10.1159/000547537","DOIUrl":"10.1159/000547537","url":null,"abstract":"<p><p><p>Introduction: Azithromycin, with its antimicrobial and anti-inflammatory properties, has been explored as a potential option for preventing bronchopulmonary dysplasia (BPD) in preterm infants.</p><p><strong>Objective: </strong>We performed a meta-analysis of randomized controlled trials (RCTs) comparing azithromycin with placebo for the prevention of BPD in preterm infants.</p><p><strong>Methods: </strong>PubMed, Scopus, <ext-link ext-link-type=\"uri\" xlink:href=\"http://ClinicalTrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">ClinicalTrials.gov</ext-link>, and Cochrane Central databases were searched for studies comparing azithromycin versus placebo in preterm infants. Outcomes of interest included the composite of BPD and death, BPD, death, grade 2 or higher necrotizing enterocolitis (NEC), grade 3 or 4 intraventricular hemorrhage (IVH), retinopathy of prematurity (RoP), duration of mechanical ventilation, and postnatal corticosteroid requirement. Random-effects model was used to generate risk ratio (RR), mean difference (MD), and 95% confidence interval (CI) (CRD42024558752).</p><p><strong>Results: </strong>The meta-analysis included 6 RCTs including 1,360 infants (azithromycin n = 680, 50%). The composite of BPD or death (RR: 0.95; 95% CI: 0.83-1.10; p = 0.53; I2 = 50.2%), BPD (RR: 0.98; 95% CI: 0.83-1.15; p = 0.77; I2 = 38.1%), death (RR: 0.88; 95% CI: 0.66-1.19; p = 0.41; I2 = 0%), NEC (RR: 0.94; 95% CI: 0.69-1.26; p = 0.67; I2 = 0%), IVH (RR: 1.22; 95% CI: 0.89-1.68; p = 0.22; I2 = 3.5%), RoP (RR: 1.35; 95% CI: 0.43-4.28; p = 0.61; I2 = 76.3%), duration of mechanical ventilation (MD: 0.13; 95% CI: -1.35 to 1.60; p = 0.87; I2 = 0%), and postnatal corticosteroid requirement (RR: 0.84; 95% CI: 0.64-1.08; p = 0.18; I2 = 34.5%) were similar between the groups.</p><p><strong>Conclusion: </strong>In preterm infants, azithromycin did not significantly change the risk of adverse clinical outcomes compared with placebo. </p>.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"74-83"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12903889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to Prevent Intraventricular Haemorrhage in Preterm Neonates: An Umbrella Review of Systematic Reviews and Meta-Analyses.","authors":"Mayuri Bhanushali, Haribalakrishna Balasubramanian, Hemant Sharma, Anitha Ananthan, Rajendra Prasad Anne, Richa Choubey, Swarup Kumar Dash, Nandkishor S Kabra","doi":"10.1159/000550551","DOIUrl":"10.1159/000550551","url":null,"abstract":"<p><strong>Introduction: </strong>Intraventricular haemorrhage (IVH) leads to significant morbidity among preterm infants. We conducted an overview of systematic reviews of RCTs assessing the effects of perinatal/neonatal interventions in reducing IVH among preterm infants.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane database for systematic reviews, and systematic review repositories were searched for meta-analyses of RCTs involving preterm infants or women at high risk of preterm birth and reporting on IVH. Metaumbrella package of R software was used to pool outcome data for each intervention. Quality of the systematic reviews was assessed using AMSTAR 2 tool. Certainty of evidence (COE) was reported using GRADE recommendations.</p><p><strong>Results: </strong>A total of 148 systematic reviews (110 Cochrane vs. 38 non-Cochrane) were included. Postnatal interventions were reported in 118 reviews. Severe IVH was reported in 100/148 reviews that included 39,483 infants and 20,400 antenatal women. In total, 78% (n = 116) of the reviews were rated high or moderate quality on AMSTAR-2 assessment. Antenatal corticosteroids and magnesium sulphate for imminent preterm birth, volume-targeted ventilation, early rescue surfactant administration through thin catheter, prophylactic indomethacin significantly reduced the rates of severe IVH (moderate COE). Use of respiratory function monitors and heated humidified respiratory gases in the delivery room and early prophylactic erythropoietin supplementation for preterm infants may reduce the rates of severe IVH (very low COE).</p><p><strong>Discussion: </strong>Antenatal steroids and magnesium sulphate administration and early neonatal lung protective strategies reduce the rates of IVH in preterm neonates. Adequately powered RCTs evaluating IVH care bundles with long-term follow-up are required.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"377-390"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128011","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}