620 - Evidence Mapping and Gap Analysis of Newborn Systematic Reviews and Meta-Analyses within the Cochrane Library

Publication Number: 2605.620

Alyson R. Barnes, Mount Vernon High School, Marionville, MO, United States; Roger F. Soll, Robert Larner, M.D., College of Medicine at the University of Vermont, Hinesburg, VT, United States; Jeanne-Marie Guise, Beth Israel Deaconess Medical Center, Boston, MA, United States; Brian King, Harvard Medical School, Boston, MA, United States; John Zupancic, Harvard Medical School, Boston, MA, United States; Susanne Hay, Harvard Medical School, Boston, MA, United States

Background: The rapidly expanding evidence base of neonatology outstrips the pace at which thoughtful systematic reviews can be performed. To optimize our understanding of current data, evidence synthesis organizations must make prioritization decisions as to which topics should be reviewed or updated. An understanding of the current systematic review landscape is essential for recognizing areas of saturation versus areas of need.

Objective: To describe the topical coverage areas of all extant Cochrane Neonatal Reviews.

Design/Methods: We searched the Cochrane Database of Systematic Reviews for systematic reviews indexed by "Neonatal" under Topic or Cochrane Group between 1995 and October 15, 2025. We extracted PICO (Population, Intervention, Comparison, Outcome) information from the database citation, as well as the date of the most recent update. Logistic regression was performed to assess trends over time.

Results: A total of 366 unique Cochrane Neonatal Reviews provided PICO information and were included in our analysis. The most commonly studied (non-mutually-exclusive) populations were Preterm, not otherwise specified (210 reviews; 57.4%), followed by Very Preterm (83; 22.7%). Only 19.7% of reviews included Term, 4.6% specifically included Late Preterm, and 6.6% included Extremely Preterm in the PICO (Figure 1a). Considering both active interventions and comparators, Human Milk was the most commonly listed (4.5%), closely followed by Ventilator (4.4%) (Figure 1b). Placebo or Usual Care was listed as a comparator in 194 reviews (53.0%). Mortality (239 reviews; 65.3%), Neurodevelopment (130; 35.5%), and Bronchopulmonary Dysplasia (84; 23.0%) were the most frequently listed outcomes (Figure 1c). Considering reviews denoting any preterm population, the total proportion of reviews dealing with prematurity was 70%, and there was no change in this over time (p=0.329).

Conclusion(s): Cochrane Neonatal Reviews span a broad range of unique topics, with unlikely overt saturation, although potential for important gaps. These gaps could include specific topic areas, as well as reviews considering late preterm populations. This mapping can assist prioritization when planning further reviews and research.

Figure 1
Proportions of a) gestational age groups, b) most frequent active interventions and comparators, and c) most frequently reviewed outcomes. Proportions for b) calculated out of included review intervention and comparator sections; proportions for a) and c) out of included reviews.
CPAP = Continuous Positive Airway Pressure