Body positioning for spontaneously breathing preterm infants with apnoea

Background It has been proposed that the use of body positioning may be a more effective way to reduce clinically significant apnoea than the use of more invasive measures. Objectives To determine the effect of body positioning on cardiorespiratory functioning in spontaneously breathing preterm infants with clinically significant apnoea. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2011), MEDLINE (1966 to March 2011), EMBASE (1988 to March 2011) and CINAHL (1988 to March 2011), abstracts of conference proceedings and citations of published articles. Selection Criteria All studies in which infants or their sequence of body positioning was randomised or quasi-randomised. We included cross-over studies. Data collection and analysis We performed assessment of trial quality, data extraction and synthesis of data using standard methods of the Cochrane Neonatal Review Group. Main results Five studies (N = 114) were eligible for inclusion. None of the individual studies or the meta-analyses showed a reduction in apnoea, bradycardia, oxygen desaturation or oxygen saturation with body positioning (supine versus prone; prone versus right lateral; prone versus left lateral; right lateral versus left lateral; prone horizontal versus prone head elevated; right lateral horizontal versus right lateral head elevated and left lateral horizontal versus left lateral head elevated). Authors' conclusions There is insufficient evidence to determine the role of body positioning on apnoea, bradycardia, oxygen desaturation and oxygen saturation. Large randomised controlled trials are needed to determine the effect of body positioning on cardiorespiratory function in spontaneously breathing preterm infants.