Context

Neonatal respiratory distress associated with prematurity, surfactant deficiency, sepsis and birth asphyxia, significantly contributes to morbidity and mortality globally. In high income countries, nasal continuous positive airway pressure (CPAP) initiated in the delivery room, compared with intubation and mechanical ventilation, reduces death or bronchopulmonary dysplasia in preterm babies born <32 weeks’ gestation.1 In low and middle income countries (LMIC) with limited resources, bubble CPAP may provide affordable, safe and effective respiratory support in hospital settings.

The systematic review and meta-analysis examines the evidence for the efficacy and safety of CPAP (particularly bubble CPAP) as a primary respiratory support in neonates <28 days old with respiratory distress in LMIC hospital settings.