Effectiveness of nasogastric versus orogastric tube feeding in preterm infants: A systematic review and meta‐analysis
Bibliographic record
Abstract
OBJECTIVES: This systematic review and meta-analysis evaluated the effectiveness of nasogastric versus orogastric tube feeding on feeding performance in preterm neonates. METHODS: Randomized, quasi-randomized, and cross-over trials published in peer-reviewed journals with no language or country restrictions were included. Preterm neonates (<37 weeks) receiving nasogastric or orogastric enteral feeding until full oral feeds were established formed the exposure and comparison groups. PRIMARY OUTCOME: time to achieve full enteral feeding; secondary outcomes: feeding performance, growth, and adverse events. A comprehensive literature search across multiple databases was conducted up to January 2024. Two authors independently screened studies, assessed the risk of bias, and performed a meta-analysis using a random effects model. Evidence levels were determined following Grades of Recommendation, Assessment, Development, and Evaluation guidelines. RESULTS: Six studies, including 273 preterm neonates, were included. Nasogastric feeding reduced the time to achieve full enteral feeds compared to orogastric feeding (mean difference [MD], -1.62 days; 95% confidence interval [CI], -2.25 to -0.99 days) with very low certainty of evidence. Combined episodes of bradycardia and desaturation per hour were higher in nasogastric feeding than orogastric feeding (MD, 0.24; 95% CI, 0.14-0.34), as were episodes of bradycardia (MD, 0.08; 95% CI, 0.04-0.13) and desaturation (MD, 0.16; 95% CI, 0.10-0.22). No significant differences were found in time to regain birth weight, apnea, necrotizing enterocolitis, or sepsis. CONCLUSIONS: Nasogastric tube feeding reduces the time to achieve full enteral feeds but increases episodes of bradycardia and desaturation compared to orogastric feeding in preterm neonates. Cautious interpretation is required as the low to very low certainty evidence highlights the need for larger, well-designed trials for evidence-based recommendations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.041 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.025 | 0.046 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".