Mary Crosse project: systematic reviews and grading the value of neonatal tests in predicting long term outcomes

A series of systematic reviews and meta-analyses will be undertaken to determine, amongst neonates, the ability of various tests and measures to predict infant, childhood and adult outcomes. We will search Medline, Embase, Cochrane Library, MEDION, citation lists of review articles and eligible primary articles and will contact experts in the field. Independent reviewers will select studies, extract data and assess study quality according to established criteria. Language restrictions will not be applied. Data synthesis will involve meta-analysis (where appropriate), exploration of heterogeneity and publication bias. Evidence collated will be graded for its quality to support decision making.The project will collate, synthesise and evaluate the available evidence concerning the value of tests of neonatal wellbeing to predict long term outcomes. The systematic reviews will assess the quality of available evidence and identify tests with the strongest association with outcomes, and assess their economic value. The output of this project will help formulate practice recommendations.Events before birth, condition at birth, events immediately following birth, and condition in early childhood are linked together, and may have implications for health and disease in adulthood [1]. A variety of parameters are used to assess neonatal wellbeing such as the APGAR score,[2] umbilical cord pH, [3] need for neonatal intensive care and growth measurements including birth weight, head circumference and skin fold thickness [4]. Studies of tests or interventions in pregnancy and labour often use these factors as outcome measures [5]. Similarly, complications in childhood such as cerebral palsy may be attributed to antenatal or intrapartum events where there is an abnormal neonatal test such as low cord pH or low birth weight. However, there are conflicting results in existing studies regarding the strength of association between an abnormal neonatal test and adverse outcomes. A compre