Association Between Delivery Room Continuous Positive Airway Pressure and Neonatal Outcomes in Late Preterm and Term Infants: A Systematic Review and Meta-Analysis.

Authors

Yoxin Chin, Maclean Hill, Arun Sett, Niranjan Thomas, Abdul Razak

Published in

Journal of paediatrics and child health. Jul 28, 2026. Epub Jul 28, 2026.

Abstract

To explore the effects of delivery room continuous positive airway pressure (DR-CPAP) in late preterm and term infants.
Systematic review and meta-analysis.
Cochrane Library, Embase, Emcare and MEDLINE were searched through March 26, 2025.
Observational studies and randomised clinical trials (RCTs) comparing outcomes in infants receiving DR-CPAP versus no DR-CPAP.
Meta-analyses were conducted using a random-effects model to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Risk of bias was assessed per Cochrane guidelines, and certainty of evidence was graded using the GRADE framework.
Pneumothorax.
Seven studies (five non-randomised, two RCTs) involving 135 472 infants were included. In observational data, DR-CPAP was associated with a significant increased risk of pneumothorax (unadjusted OR: 45.79; 95% CI: 31.47-66.63; moderate certainty; adjusted OR: 24.18; 95% CI: 2.32-251.63; moderate certainty). RCTs reported no pneumothorax events in both groups, preventing meta-analytic estimation. DR-CPAP was also associated with increased use of surfactant in observational studies (OR: 5.68; 95% CI: 2.97-10.86; very low certainty). For neonatal intensive care unit admissions, DR-CPAP was associated with significantly higher odds in observational studies (OR: 14.56; 95% CI: 13.27-15.98; moderate certainty), but significantly lower odds in RCTs (OR: 0.24; 95% CI: 0.09-0.63; very low certainty).
DR-CPAP was associated with potential harm in observational studies, though confounding cannot be excluded. Evidence from RCTs remains limited, and is of very low certainty. Well-designed, robust clinical studies are urgently needed to guide practice.

PMID:
42517258
Bibliographic data and abstract were imported from PubMed on 28 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.