SynthesisFrontiers in pediatrics2025
Quality improvement interventions to prevent neonatal necrotizing enterocolitis: a systematic review.
Synthesis in Frontiers in pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Neonatal necrotizing enterocolitis (NEC) is the leading cause of death due to gastrointestinal disease in preterm neonates. Quality improvement bundles could reduce the incidence of NEC in preterm infants, but their replication in neonatal intensive care units has had inconsistent outcomes. Objective: Quality improvement may reduce the incidence and severity of NEC in preterm infants. We evaluated quality improvement interventions (QIIs) that sought to prevent or reduce the severity of NEC. Methods: PubMed, Embase, Cochrane Library, Web of Science, Wanfang Database, China National Knowledge Infrastructure (CNKI), VIP Chinese Journal Service Platform (VIP), Chinese BioMedical Literature Database (CBM), and citations of selected articles were searched. QIIs that reduced the incidence or severity of NEC in preterm infants were the primary outcome. Paired reviewers independently extracted data from selected studies. Results: In total, 13 quality improvement interventions involving 17,961 infants were included. Nearly all of the QIIs included improving breastfeeding rates. Moreover, 16 of the 19 QIIs resulted in a significant reduction in the incidence of NEC after their implementation. Application of the quality criteria of the quality improvement showed that all the interventions were considered to be of medium to high quality, with the lowest score being 8 and 13 of the interventions having scores more than 10. The studies had heterogeneity with significant variations in intervention characteristics, implementation units, personnel, sample size, time, and outcomes. Conclusion: QIIs resulted in reductions in the incidence and severity of NEC in preterm infants in some but not all settings. The specific interventions and quality improvement methods that were responsible for those reductions and why they were successful in some settings but not others are unclear. This systematic review can assist teams in identifying potentially better practices for reducing NEC. Systematic Reviews Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024601939, PROSPERO (CRD42024601939).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.