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The effect of incubator humidity on morbidity and mortality in preterm infants: a systematic review
Zhiqin Chen1,2, Ruizi Lin1,2, Huixin Wang3,4
1Department of Neonatology, Guangzhou Key Laboratory of Neonatal Intestinal Diseases, The Third Afffliated Hospital, Guangzhou Medical University, Guangzhou, China.
Insights
High incubator humidity increases infection risk in preterm infants. Further research is needed to understand optimal humidity levels and their long-term effects on infant health.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Critical Care
Background:
- No standardized incubator humidity levels exist for preterm infants.
- Current research on incubator humidity requires synthesis via meta-analysis.
Purpose of the Study:
- To evaluate the association between varying incubator humidity levels and clinical outcomes in preterm infants.
- To synthesize evidence on the impact of incubator humidity on infant health.
Main Methods:
- Systematic search of multiple databases (PubMed, MEDLINE, Embase, etc.) from January 2000 to December 2023.
- Inclusion of randomized controlled trials and cohort studies (prospective and retrospective) of preterm infants (<34 weeks gestation).
- Analysis focused on infection rates, bronchopulmonary dysplasia incidence, and predischarge mortality.
Main Results:
- A high humidity level was associated with an increased incidence of infection in preterm infants (RR=1.26, 95% CI 1.02-1.55, P=0.03).
- No significant differences were observed in bronchopulmonary dysplasia incidence or infant mortality between high and low humidity groups.
- The review included 3 RCTs and 3 cohort studies, totaling 801 preterm infants.
Conclusions:
- Elevated incubator humidity significantly impacts infection rates in preterm infants.
- Limited evidence exists due to significant study heterogeneity and lack of data on humidity duration and adjustment schemes.
- Further research is warranted to establish optimal incubator humidity protocols.
Purpose:
To assess the association between different incubator humidity levels and clinical outcomes in preterm infants.
Background:
Since there is no well-accepted standard for delivery of incubator humidity for preterm infants. A meta-analysis is needed to summarize the status of current research.
Methods:
Databases searched included PubMed, MEDLINE, the Cochrane Library, Embase, Ovid, Google scholar and Web of Science, published between January 2000 and December 2023. Randomized control trials, prospective cohort studies and retrospective cohort studies were included if they assessed how different incubator humidity levels affected preterm infants with a gestational age < 34 weeks, published in English. Infection rates, the incidence of bronchopulmonary dysplasia and predischarge mortality were evaluated.
Results:
Included in this review were 3 randomized control trials and 3 cohort studies including 801 preterm infants. Findings revealed that a high humidity level increased the incidence of infection in preterm infants (RR = 1.26, 95% CI 1.02, 1.55, P = 0.03). No significant difference was found between a high incubator humidity level and the incidence of bronchopulmonary dysplasia or infant mortality.
Conclusions:
This study found that high humidity levels had a significant impact on the incidence of infection. Current evidence is limited by signifcant heterogeneity across studies, lack of data related to regarding the effects of factors such as humidity duration and humidity adjustment schemes on the outcomes.
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