Morag Iris, Ohlsson Arne
Neonatal Unit, Mayanei HaYeshua Medical Centre, Bnei Brak, Israel.
Cochrane Database Syst Rev. 2011 Jan 19(1):CD006982. doi: 10.1002/14651858.CD006982.pub2.
The potential benefits and harms of different lighting in neonatal units have not been quantified.
To compare the effectiveness of cycled lighting (CL) (approximately 12 hours of light on and 12 hours of light off) with irregularly dimmed light or near darkness (ND) and with continuous bright light (CBL) on growth in preterm infants at three and six months of age.
Electronic searches of the literature were conducted (in May 2010) of the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, CINAHL and abstracts from Pediatric Academic Societies' annual meetings.
Randomised or quasi-randomised trials of CL versus ND or CBL in preterm and low birth weight infants.
Data collection and analyses were performed according to the methods of the Cochrane Neonatal Review Group.
Five studies enrolling 387 infants compared CL to ND. No study reported on weight at three or six months. In one study (n = 40) there was no statistically significant difference in weight at four months between the CL and the ND groups. In another study (n = 62) the ratio of day-night activity prior to discharge favoured the CL group (mean difference 0.18, 95% CI 0.17 to 0.19) indicating 18% more activity during day than night in the CL group compared to the ND group. Two studies (n = 189) reported on retinopathy of prematurity (stage ≥ 3). There was no statistically significant difference between the CL and ND groups (typical RR 0.53, 95% CI 0.25 to 1.11, I(2) = 0%; typical RD -0.09, 95% CI -0.19 to 0.01, I(2) = 0%).Two studies enrolling 82 infants compared CL to CBL. One study (n = 41) reported higher mean weight at three months corrected age in infants cared for in the CL nursery (P < 0.02) and lower mean number of hours spent awake in 24 hours at three months (P < 0.005). In one study (n = 41) days on a ventilator were reduced in the CL group (mean difference -18, 95% CI -31 to -5 days).For many outcomes the trends favoured CL versus ND as well as CL versus CBL.
AUTHORS' CONCLUSIONS: Trials assessing the effect of CL have enrolled 469 infants. Trends for many outcomes favoured cycled light (CL) compared to near darkness (ND) and CL compared to continuous bright light (CBL) The studies may have lacked significance due to a lack of statistical power. Future research should focus on comparing CL to ND.
新生儿病房不同光照的潜在益处和危害尚未得到量化。
比较循环光照（CL）（约12小时光照和12小时熄灯）与不规则调光或接近黑暗（ND）以及持续强光（CBL）对早产婴儿3个月和6个月时生长发育的影响。
于2010年5月对Cochrane对照试验中心注册库（CENTRAL）（Cochrane图书馆）、MEDLINE、EMBASE、CINAHL以及儿科学术协会年会摘要进行了文献电子检索。
早产和低体重婴儿中CL与ND或CBL对比的随机或半随机试验。
根据Cochrane新生儿综述组的方法进行数据收集和分析。
五项纳入387名婴儿的研究将CL与ND进行了比较。没有研究报告3个月或6个月时的体重情况。在一项研究（n = 40）中，CL组和ND组在4个月时的体重无统计学显著差异。在另一项研究（n = 62）中，出院前昼夜活动比例有利于CL组（平均差值0.18，95%可信区间0.17至0.19），表明CL组白天的活动比ND组多18%。两项研究（n = 189）报告了早产儿视网膜病变（≥3期）情况。CL组和ND组之间无统计学显著差异（典型相对危险度0.53，95%可信区间0.25至1.11，I² = 0%；典型绝对危险度差值-0.09，95%可信区间-0.19至0.01，I² = 0%）。两项纳入82名婴儿的研究将CL与CBL进行了比较。一项研究（n = 41）报告称，在CL育婴室护理的婴儿在矫正年龄3个月时平均体重较高（P < 0.02），且在3个月时24小时内平均清醒时间较短（P < 0.005）。在一项研究（n = 41）中，CL组的呼吸机使用天数减少（平均差值-18，95%可信区间-31至-5天）。对于许多结局指标，与ND以及与CBL相比，趋势均有利于CL。
评估CL效果的试验纳入了469名婴儿。与接近黑暗（ND）以及与持续强光（CBL）相比，许多结局指标的趋势有利于循环光照（CL）。由于缺乏统计效力，这些研究可能未达到显著性。未来的研究应聚焦于CL与ND的比较。
