Does the prone position have the impact to the neonate’s respiratory distress syndromes? A systematic review

Background: Neonatal respiratory distress syndrome (N-RDS) is a leading cause of morbidity and mortality in neonates. The prone position is increasingly recognized as a beneficial strategy for managing N-RDS. This study aims to evaluate the effects of prone positioning on oxygen saturation (SpO2), heart rate (HR), respiratory rate (RR), and ventilator parameters, including fraction of inspiratory oxygen (FiO2), peak end-expiratory pressure (PEEP), and oxygenation index (OI), in neonates with N-RDS. Methods: A systematic review was conducted, analyzing six studies selected from 1,241 articles identified through Google Scholar, Mendeley, PubMed, and Cochrane Library databases between 2014 and 2024. The search was limited to randomized controlled trials (RCTs) published in English involving neonatal patients. Results: The prone position significantly improved SpO2, HR, RR, and ventilator parameters in neonates with N-RDS. It also reduced the need for mechanical ventilation, emphasizing its role as an effective, non-invasive, and cost-effective intervention for managing N-RDS and enhancing clinical outcomes. Conclusion: Prone positioning is an effective strategy for managing N-RDS. It improves oxygenation and ventilatory outcomes while reducing the necessity for invasive interventions. Further research with larger and more homogeneous samples is required to confirm these findings and better understand the broader impact of prone positioning in neonatal care.