A meta-analysis could show a slight superiority of animal-derived surfactants compared to protein-free surfactants regarding mortality (RR 0.89, 95% CI 0.79–0.99, n = 5413) and, with borderline significance, the combined outcome BPD at 28 days of life or death (RR 0.95, 95% CI 0.91–1.00, n = 3811) [ 38 ].
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Evidence for the Management of Bronchopulmonary Dysplasia in Very Preterm Infants.
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A meta-analysis of observational studies analyzing these particular infants born before 25 weeks of gestation also found a highly significant reduction in mortality (odds ratio (OR) 0.48, 95% CI 0.42–0.55, n = 13,443) [ 21 ].
Another meta-analysis, on which the NIH Consensus Statement was based, found a borderline significant effect from 14 RCTs for the combined outcome of death or BPD (RR 0.93, 95% CI 0.86–0.99, n = 3129) [ 129 , 130 ].