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    Systematic review and network meta-analysis with individual participant data on cord management at preterm birth (iCOMP): study protocol.

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    Authors
    Seidler, Anna Lene
    Duley, Lelia
    Katheria, Anup C
    De Paco Matallana, Catalina
    Dempsey, Eugene
    Rabe, Heike
    Kattwinkel, John
    Mercer, Judith
    Josephsen, Justin
    Fairchild, Karen
    Andersson, Ola
    Hosono, Shigeharu
    Sundaram, Venkataseshan
    Datta, Vikram
    El-Naggar, Walid
    Tarnow-Mordi, William
    Debray, Thomas
    Hooper, Stuart B
    Kluckow, Martin
    Polglase, Graeme
    Davis, Peter G
    Montgomery, Alan
    Hunter, Kylie E
    Barba, Angie
    Simes, John
    Askie, Lisa
    Show allShow less
    Issue Date
    2020-03-29
    Keywords
    individual participant data meta-analysis
    network meta-analysis
    placental transfusion
    preterm birth
    prospective meta-analysis
    umbilical cord clamping
    umbilical cord milking
    
    Metadata
    Show full item record
    Journal
    BMJ open
    URI
    http://hdl.handle.net/10147/629483
    DOI
    10.1136/bmjopen-2019-034595
    PubMed ID
    32229522
    Abstract
    ntroduction: Timing of cord clamping and other cord management strategies may improve outcomes at preterm birth. However, it is unclear whether benefits apply to all preterm subgroups. Previous and current trials compare various policies, including time-based or physiology-based deferred cord clamping, and cord milking. Individual participant data (IPD) enable exploration of different strategies within subgroups. Network meta-analysis (NMA) enables comparison and ranking of all available interventions using a combination of direct and indirect comparisons. Objectives: (1) To evaluate the effectiveness of cord management strategies for preterm infants on neonatal mortality and morbidity overall and for different participant characteristics using IPD meta-analysis. (2) To evaluate and rank the effect of different cord management strategies for preterm births on mortality and other key outcomes using NMA. Methods and analysis: Systematic searches of Medline, Embase, clinical trial registries, and other sources for all ongoing and completed randomised controlled trials comparing cord management strategies at preterm birth (before 37 weeks' gestation) have been completed up to 13 February 2019, but will be updated regularly to include additional trials. IPD will be sought for all trials; aggregate summary data will be included where IPD are unavailable. First, deferred clamping and cord milking will be compared with immediate clamping in pairwise IPD meta-analyses. The primary outcome will be death prior to hospital discharge. Effect differences will be explored for prespecified participant subgroups. Second, all identified cord management strategies will be compared and ranked in an IPD NMA for the primary outcome and the key secondary outcomes. Treatment effect differences by participant characteristics will be identified. Inconsistency and heterogeneity will be explored.
    Item Type
    Article
    Other
    Language
    en
    EISSN
    2044-6055
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjopen-2019-034595
    Scopus Count
    Collections
    Cork University Maternity Hospital

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