Table 4.

Mortality rates during hospitalisation and calculated risk ratios

Intervention	Control	Author (year)	Mortality outcome intervention, n (%)	Mortality outcome control, n (%)	RR	95% CI	P value	GRADE quality of evidence
Feeding interventions
3-hour feeding schedule	2-hour feeding schedule	Tali et al67 (2016)	0	0	NA	NA	NA	⨁⨁◯◯ Low*
Infection prevention
rhG-CSF	Empirical antibiotics alone	Aktas et al48 (2015)	10 (30.3)	6 (26.1)	1.16	0.49–2.74	0.73	⨁⨁◯◯ Low*
Synbiotics	Standard care	Nandhini et al62 (2016)	10 (9.3)	9 (8.2)	1.13	0.48–2.68	0.78	⨁⨁◯◯ Low*
Lactobacillus sporogenes	Breast milk or formula alone	Sari et al64 (2011)	3 (2.7)	4 (3.6)	0.76	0.17–3.30	0.71	⨁⨁◯◯ Low*
Prevention and treatment of respiratory morbidity
Nasal-jet CPAP	Bubble CPAP	Bhatti et al52 (2015)	20 (25)	16 (18)	1.41	0.78–2.52	0.25	⨁⨁⨁◯ Moderate†
Bubble CPAP	Flow driver CPAP	Mazmanyan et al60 (2016)	3 (4.5)	1 (1.7)	2.68	0.29–25.08	0.39	⨁⨁◯◯ Low*‡
	Preintervention period	Okello et al63 (2019)	58 (26.5)	62 (39.2)	0.68	0.50–0.91	0.01	⨁⨁◯◯ Low§
			VLBW 36 (19.7)	41 (31.5)	0.62	0.42–0.92	0.02	⨁⨁◯◯ Low§
			ELBW 22 (61.1)	21 (75)	0.82	0.58–1.14	0.23	⨁◯◯◯ Very low†§
	Ventilator-derived CPAP	Tagare et al66 (2013)	4 (7)	5 (8.8)	0.80	0.23–2.83	0.73	⨁⨁◯◯ Low*
Binasal prong	Nasal mask for applying nasal CPAP	Say et al65 (2016)	4 (5.4)	7 (9.3)	0.56	0.17–1.85	0.34	⨁⨁◯◯ Low*
Surfactant Poractant alfa	Beractant	Gharehbaghi et al54 (2010)	21 (26.6)	15 (21.1)	1.26	0.70–2.25	0.44	⨁⨁⨁◯ Moderate†
LISA method	Conventional INSURE method	Halim et al56 (2018)	19 (38)	28 (56)	0.68	0.44–1.04	0.08	⨁⨁⨁◯ Moderate†
Goat lung surfactant extract	Beractant	Jain et al57 (2019)	21 (40.4)	14 (30.4)	1.33	0.77–2.30	0.31	⨁⨁⨁◯ Moderate†
Vitamin A supplementation	Placebo	Basu et al51 (2019)	9 (9.2)	16 (16.3)	0.56	0.26–1.21	0.14	⨁⨁⨁◯ Moderate†
Pulse oximetry	Preintervention period	Graham et al55 (2019)	82 (13.4)	326 (17.4)	1.12	0.56–2.26¶	0.76¶	⨁⨁⨁◯ Moderate†
Full O2 system	Preintervention period		203 (19.5)	326 (17.4)	0.99¶	0.61–1.59¶	0.96¶	⨁⨁⨁◯ Moderate†
Volume-guaranteed ventilation	Pressure-controlled ventilation	Krishna et al58 (2019)	4 (10)	5 (12.2)	0.82	0.24–2.84	0.75	⨁⨁◯◯ Low*
Aminophylline	Caffeine	Kumar et al59 (2017)	16 (21.9)	15 (21.4)	1.02	0.55–1.91	0.94	⨁⨁◯◯ Low†**
High flow nasal cannula	Nasal CPAP	Murki et al61 (2018)	4 (3.0)	3 (2.1)	1.39	0.32–6.11	0.66	⨁⨁◯◯ Low*
Strategies of newborn care
Maternal nursing care	Special care baby unit	Arif et al49 (1999)	43 (28.5)	141 (66.8)	0.43	0.33–0.56	0·0000	⨁⨁⨁◯ Moderate**
Stepdown unit	Preintervention period	Bhutta et al53 (2004)	55 (17.3)	63 (33)	0.52	0.38–0.72	0·0001	⨁⨁⨁◯ Moderate§
Others
Oral paracetamol for PDA closure	Oral ibuprofen	Balachander et al50 (2018)	12 (21.8)	11 (20)	1.10	0.53–2.26	0.81	⨁⨁◯◯ Low*
Polythene tobacco wrap	Standard nursing procedure	Van Den Bosch et al68 (1996)	0	6 (54.5)	0.06	0·0036–0.93	0.04	⨁⨁◯◯ Low†**

*Insufficient sample to meet optimal information size (OIS) criteria with very few events and 95% CI fails to exclude important benefit or harm.

†Insufficient sample to meet OIS criteria and/or 95% CI close to or crosses line of no effect or fails to exclude important benefit or harm.

‡Derived from the meta-analysis pooling the results of both studies.

§Serious risk of selection bias.

¶Mixed-model odds ratio; accounted for the clustering of patients within hospitals and adjusted for time trends.

**Substantial loss to follow-up in relation to the number of events and failure to adhere to the intention-to-treat principle.