A Network Meta-Analysis of Complementary Interventions for Weight Gain and Hospital Stay Reduction

Area of Science:

• Neonatal Medicine
• Developmental Pediatrics
• Evidence-Based Healthcare

Background:

• Preterm infants often experience suboptimal weight gain, necessitating effective interventions.
• Optimizing growth in preterm infants is crucial for long-term health and developmental outcomes.
• Network meta-analysis provides a robust framework for comparing multiple interventions simultaneously.

Purpose of the Study:

• To systematically compare the efficacy of various complementary interventions for promoting weight gain in preterm infants.
• To identify the most effective interventions through a network meta-analysis (NMA).

Main Methods:

• A systematic review and NMA were conducted across six databases, including randomized controlled trials (RCTs).
• Data extraction and bias assessment were performed independently by two reviewers.
• Bayesian meta-analysis in GeMTC software reported effects as standardized mean differences (SMDs); Confidence In Network Meta-Analysis (CINeMA) evaluated evidence certainty.

Main Results:

• Sixty-one RCTs involving 5858 preterm infants were analyzed.
• Tactile kinesthetic stimulation demonstrated the greatest weight gain improvement (SMD 8.9).
• Multisensory stimulation (SMD 7.0), its combination with music therapy (SMD 7.9), kinesthetic stimulation (SMD 1.3), and massage (SMD 0.70) also showed significant benefits. Oral stimulation reduced hospitalization duration (SMD -0.49).

Conclusions:

• Tactile kinesthetic stimulation, multisensory stimulation, and massage-based interventions significantly enhance weight gain in preterm infants.
• These findings support the integration of these complementary therapies into standard neonatal care protocols.
• Implementing these interventions can optimize growth trajectories and improve overall outcomes for preterm neonates.