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Systematic review and network meta-analysis with individual participant data on cord management at preterm birth (iCOMP): study protocol.
Seidler, Anna Lene Duley, Lelia Katheria, Anup C De Paco Matallana, Catalina Dempsey, Eugene Rabe, Heike Kattwinkel, John Mercer, Judith Josephsen, Justin Fairchild, Karen
Seidler, Anna Lene
Duley, Lelia
Katheria, Anup C
De Paco Matallana, Catalina
Dempsey, Eugene
Rabe, Heike
Kattwinkel, John
Mercer, Judith
Josephsen, Justin
Fairchild, Karen
Author
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
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
Advisors
Editors
Other Contributors
Departments
Date
2020-03-29
Date Submitted
Keywords
individual participant data meta-analysis
network meta-analysis
placental transfusion
preterm birth
prospective meta-analysis
umbilical cord clamping
umbilical cord milking
network meta-analysis
placental transfusion
preterm birth
prospective meta-analysis
umbilical cord clamping
umbilical cord milking
Other Subjects
Subject Mesh
Planned Date
Start Date
Collaborators
Principal Investigators
Files
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e034595.full.pdf
Adobe PDF, 1.19 MB
Alternative Titles
Publisher
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.
Language
en
Citation
ISSN
eISSN
2044-6055
ISBN
DOI
10.1136/bmjopen-2019-034595
PMID
32229522