{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T04:21:17Z","timestamp":1793852477026,"version":"4.6.1"},"reference-count":81,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"Importance<\/jats:title>Resuscitation with lower fractional inspired oxygen (FiO2<\/jats:sub>) reduces mortality in term and near-term infants but the impact of this practice on very preterm infants is unclear.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the relative effectiveness of initial FiO2<\/jats:sub> on reducing mortality, severe morbidities, and oxygen saturations (SpO2<\/jats:sub>) in preterm infants born at less than 32 weeks\u2019 gestation using network meta-analysis (NMA) of individual participant data (IPD).<\/jats:p><\/jats:sec>Data Sources<\/jats:title>MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov, and WHO ICTRP from 1980 to October 10, 2023.<\/jats:p><\/jats:sec>Study Selection<\/jats:title>Eligible studies were randomized clinical trials enrolling infants born at less than 32 weeks\u2019 gestation comparing at least 2 initial oxygen concentrations for delivery room resuscitation, defined as either low (\u22640.3), intermediate (0.5-0.65), or high (\u22650.90) FiO2<\/jats:sub>.<\/jats:p><\/jats:sec>Data Extraction and Synthesis<\/jats:title>Investigators from eligible studies were invited to provide IPD. Data were processed and checked for quality and integrity. One-stage contrast-based bayesian IPD-NMA was performed with noninformative priors and random effects and adjusted for key covariates.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was all-cause mortality at hospital discharge. Secondary outcomes were morbidities of prematurity and SpO2<\/jats:sub> at 5 minutes.<\/jats:p><\/jats:sec>Results<\/jats:title>IPD were provided for 1055 infants from 12 of the 13 eligible studies (2005-2019). Resuscitation with high (\u22650.90) initial FiO2<\/jats:sub> was associated with significantly reduced mortality compared to low (\u22640.3) (odds ratio [OR], 0.45; 95% credible interval [CrI], 0.23-0.86; low certainty) and intermediate (0.5-0.65) FiO2<\/jats:sub> (OR, 0.34; 95% CrI, 0.11-0.99; very low certainty). High initial FiO2<\/jats:sub> had a 97% probability of ranking first to reduce mortality. The effects on other morbidities were inconclusive.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>High initial FiO2<\/jats:sub> (\u22650.90) may be associated with reduced mortality in preterm infants born at less than 32 weeks\u2019 gestation compared to low initial FiO2<\/jats:sub> (low certainty). High initial FiO2<\/jats:sub> is possibly associated with reduced mortality compared to intermediate initial FiO2<\/jats:sub> (very low certainty) but more evidence is required.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapediatrics.2024.1848","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T15:07:45Z","timestamp":1719241665000},"page":"774","source":"Crossref","is-referenced-by-count":77,"title":["Initial Oxygen Concentration for the Resuscitation of Infants Born at Less Than 32 Weeks\u2019 Gestation"],"prefix":"10.1001","volume":"178","author":[{"given":"James X.","family":"Sotiropoulos","sequence":"first","affiliation":[{"name":"National Health and Medical Research Council Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia"},{"name":"School of Women\u2019s and Children\u2019s Health, Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, 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