A Network Meta‐Analysis of Complementary Interventions for Weight Gain and Hospital Stay Reduction

AIM: To compare complementary interventions for improving weight gain in preterm infants via network meta-analysis (NMA). METHODS: We conducted a systematic review and NMA across six databases, including randomized controlled trials (RCTs). Two reviewers independently extracted data and assessed bias. Analyses used a Bayesian framework in GeMTC software, with effects reported as standardizes mean differences (SMDs). Confidence In Network Meta-Analysis evaluated inconsistency, ranking and evidence certainty. RESULTS: In total, 61 RCTs (n = 5858 infants) were analysed. Tactile kinesthetic stimulation showed greatest weight gain improvement (SMD 8.9, 95% CI 0.8-17). Multisensory stimulation (SMD 7.0, 6.2-7.9) and its combination with music therapy (SMD 7.9, 6.6-9.1) were also effective. Other beneficial interventions included kinesthetic stimulation (SMD 1.3, 0.091-2.5), massage (SMD 0.70, 0.39-1.0), and massage plus tactile stimulation (SMD 0.94, 0.044-1.9). Oral stimulation reduced hospitalization duration (SMD -0.49, -0.88 to -0.098). CONCLUSIONS: Tactile kinesthetic, multisensory stimulation and massage combinations significantly enhance preterm infant weight gain. These interventions should be considered in neonatal care protocols to optimize growth outcomes. TRIAL REGISTRATION: The PROSPERO registration number is CRD42024557428.