The Journal of pediatrics
October 6, 2026 · via Europe PMC
Association of Early Low Superior Vena Cava Flow among Neonates Born Very Preterm and Outcomes: A Systematic Review and Meta-Analysis.
Persad N, Mascarenhas D, Devion C, Jasani B, Deshpande P, Shah PS, Weisz DE.
AI summary — for doctors, generated from the abstract only
Low early superior vena cava flow in very preterm infants was associated with more intraventricular hemorrhage and mortality, but certainty is low.
What was studied
Systematic review and meta-analysis of 14 studies enrolling 1,366 patients assessing echocardiographic low SVC flow within 48 hours of birth.
Key findings
- Low flow was associated with adjusted odds of any IVH of 4.7 (95% CI 2.3-9.5) from 3 studies
- Unadjusted odds of severe IVH were 4.8 (95% CI 2.5-9.2) from 10 studies and all-cause mortality 4.2 (95% CI 1.8-9.7) from 6 studies
- Certainty was low or very low, and prediction intervals were wide
Clinical relevance
May support closer monitoring of preterm infants with low SVC flow, but does not show that treating flow changes outcomes.
Who should care
Limitations
Observational studies with low-certainty evidence, wide prediction intervals, and limited adjustment.
Low early SVC flow is a possible risk marker for IVH and death in very preterm infants.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To review systematically and meta-analyze the association of low superior vena cava flow (SVCF), diagnosed on echocardiography within the first 48 hours after birth, with morbidity, such as intraventricular hemorrhage (IVH), and mortality among preterm neonates (<32 weeks gestational age [GA]).
Study design
PROSPERO, Medline, EMBASE, Cochrane Library, and China National Knowledge Infrastructure Database were searched for cohort studies and randomized controlled trials including neonates < 32 weeks' GA evaluating the associations of low vs normal SVCF in the first 48 hours after birth with clinical outcomes. Data were combined using random effects meta-analyses. Main outcome measures included any and severe IVH, all-cause mortality, periventricular leukomalacia, necrotizing enterocolitis and neurodevelopmental impairment in early childhood.
Results
Fourteen original studies enrolling 1,366 patients were included. Low SVCF was associated with increased adjusted odds of any IVH (3 studies; n= 381; OR 4.7, 95% confidence interval [CI] 2.3, 9.5; 95% prediction interval [PI] 0.99, 22.1; low certainty) as well as increased unadjusted odds of severe IVH (10 studies; n=996; OR 4.8 95% CI 2.5, 9.2; PI 1.6, 15.1; low certainty) and all-cause mortality (6 studies; n=724; OR 4.2, 95% CI 1.8, 9.7; PI 0.7, 23.7; very low certainty). Low SVCF was not associated with other outcomes.
Conclusion
Low SVCF within the first 48 hours after birth for very preterm neonates may be associated with increased IVH and mortality.
DOI
10.1016/j.jpeds.2026.115362
PMID
42838408
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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