Summary of findings for the main comparison. Skin‐to‐Skin care for procedural pain in neonates ‐ summary of findings.
| Studies examining Skin‐to‐skin care vs no treatment control | ||||||
| Patient or population: procedural pain in neonates Setting: Multiple Intervention: Skin‐to‐skin care Comparison: control | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with control | Risk with Skin‐to‐skin care | |||||
| Heart rate during painful procedure | The mean heart rate during painful procedure in the intervention group was 10.78 fewer (13.63 fewer to 7.93 fewer) | ‐ | 161 (5 RCTs) | ⊕⊝⊝⊝ VERY LOW 1 2 3 | ||
| Heart rate following painful procedure | The mean heart rate following painful procedure in the intervention group was 0.08 more (4.39 fewer to 4.55 more) | ‐ | 120 (4 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| PIPP Score 30 seconds after painful procedure | The mean PIPP Score 30 seconds after painful procedure in the intervention group was 3.2 fewer (3.94 fewer to 2.47 fewer) | ‐ | 268 (5 RCTs) | ⊕⊕⊕⊝ MODERATE 4 | ||
| NIPS ‐ Proportion of infants in low or no pain during procedure | Study population | not estimable | 480 (3 RCTs) | ⊕⊝⊝⊝ VERY LOW 2 3 5 | ||
| 46 per 1,000 | 0 per 1,000 (0 to 0) | |||||
| Moderate | ||||||
| 20 per 1,000 | 0 per 1,000 (0 to 0) | |||||
| NIPS ‐ Infants in no pain during recovery | Study population | not estimable | 380 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 5 | ||
| 316 per 1,000 | 0 per 1,000 (0 to 0) | |||||
| Moderate | ||||||
| 485 per 1,000 | 0 per 1,000 (0 to 0) | |||||
| Duration of cry (seconds) following heel lance | The mean duration of cry (seconds) following heel lance in the intervention group was 34.16 fewer (42.86 fewer to 25.45 fewer) | ‐ | 33 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 5 | ||
| Duration of cry (seconds) following IM injection | The mean duration of cry (seconds) following IM injection in the intervention group was 8.83 fewer (14.63 fewer to 3.02 fewer) | ‐ | 100 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 3 | ||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; OR: Odds ratio; | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect | ||||||
1 Pooled effect significantly influenced by a single high RoB study
2 Large heterogeneity statistics
3 Confidence interval crosses MID threshold
4 Intervention is less effective against active control
5 All studies in analysis were assessed as having high RoB