Photo Credit: andresr

The following is a summary of “Clinical Guidelines for Management of Infants Born Before 25 Weeks’ Gestation: How Representative Is the Current Evidence?,” published in the November 2024 issue of Pediatrics by Peart et al. 

Clinical guidelines for infants born extremely preterm often rely on studies that inadequately represent infants born before 25 weeks’ gestation (extremely preterm). 

Researchers conducted a retrospective study to assess the representation of infants born before 25 weeks’ gestation in the evidence used to develop clinical guidelines. 

They reviewed 3 major guidelines, the 2022 European Consensus Guidelines on the Management of Respiratory Distress Syndrome, the 2017 American Academy of Pediatrics (AAP) Guidelines for Perinatal Care, and the 2020/21 International Liaison Committee on Resuscitation (ILCOR) guidelines. Referenced studies were examined and collected data on the total and estimated numbers of infants born before 25 weeks’ gestation. 

The results showed that 8 overlapping recommendations were supported by 519 studies (total participants = 409,986), of which 335 studies were RCTs with 78,325 participants. Across all studies, an estimated 59,360 participants (14.5%) were infants born before 25 weeks’ gestation, while only 5,873 participants (7.5%) in RCTs were from this group. Additionally, 196 studies (37.8%) excluded infants born before 25 weeks’ gestation entirely. 

They concluded that infants born before 25 weeks’ gestation were underrepresented in the evidence used to create clinical guidelines, emphasizing the need for research that specifically includes this population. 

Source: jpeds.com/article/S0022-3476(24)00526-2/abstract