Evidence-based neonatal care

Randomized controlled trials were introduced into neonatal care in the 1950s when high inspired oxygen concentrations were discovered to be the cause of an epidemic of blindness in preterm babies due to retinopathy of prematurity. Systematic reviews of many randomized controlled trials were published in an important textbook in 1992, ‘Effective Care of the Newborn Infant’, which was the starting point for the Neonatal Module of the Cochrane Collaboration. The 171 systematic reviews of interventions in neonatology published in the Cochrane Library provide evidence for neonatal care in many areas of the speciality. Some areas, such as management of respiratory distress with surfactant and assisted ventilation, are well covered by reviews, but others, such as resuscitation at birth and management of jaundice, are much less evidence based. Most of the systematic reviews deal with neonatal care in the developed world, and there are only a few of interest to carers in the developing world.