Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Dec 19;12(12):CD006982.
doi: 10.1002/14651858.CD006982.pub5.

Cycled light in the intensive care unit for preterm and low birth weight infants

Iris Morag  1   2 , Yu-Tian Xiao  3   4 , Matteo Bruschettini  5   6
Affiliations
Meta-Analysis

Cycled light in the intensive care unit for preterm and low birth weight infants

Iris Morag et al. Cochrane Database Syst Rev. .

Abstract

Background: Preterm and low birth weight infants are at an early stage of development, and do not receive adequate maternal circadian signals. They are often cared for over prolonged periods of hospitalisation in neonatal intensive care units (NICU), where environmental circadian stimuli are lacking. Exposure to artificial light-dark cycles may stimulate the development of the circadian system and improve clinical outcomes. However, it remains uncertain whether cycled light (CL) is preferable to near darkness (ND) or continuous bright light (CBL) in fostering development and maturation, and reducing adverse neonatal health outcomes. This is an update of an earlier Cochrane review, last published in 2016.

Objectives: To evaluate the benefits and harms of CL in preterm and low birth weight infants compared to ND or CBL.

Search methods: We searched CENTRAL, PubMed, Embase, and two trial registries to September 2023. We also checked reference lists, and searched for retractions of included studies.

Selection criteria: We included randomised controlled trials (RCTs) or quasi-RCTs in preterm infants (< 37 weeks' postmenstrual age (PMA)), or those with a low birth weight (< 2500 g), admitted and cared for in an NICU or a step-down unit, comparing CL with ND or CBL.

Data collection and analysis: We used the standard review methods of the Cochrane Neonatal Review Group to assess the methodological quality of studies. We used the fixed-effect model with risk ratio (RR) and mean difference (MD), with their 95% confidence intervals (CIs) for dichotomous data. Our primary outcomes were (1) growth at three and six months' corrected age, (2) major neurodevelopmental disability, and (3) adverse effects. Our secondary outcomes were (4) retinopathy of prematurity, (5) duration of initial hospitalisation, (6) duration of oxygen treatment, and (7) parent satisfaction. We used GRADE to assess the certainty of evidence for each outcome.

Main results: We included 20 studies with 1633 infants. Data for meta-analysis were available for 11 studies (1126 infants). One study with multiple arms was included in both comparisons. We rated the overall risk of bias at the study level as high or unclear for all 20 studies that had one or several unclear or high risk of bias judgements across the domains. Cycled light versus dimmed light or near darkness (10 studies) The evidence is very uncertain about the effect of cycled light compared to dimmed light (reduction of illumination levels) or near darkness on weight at three months (MD 24.79, 95% CI -262.33 to 311.91; 2 studies, 187 infants; very low-certainty evidence), and weight at six months (MD 202, 95% CI -109.68 to 513.68; 1 study, 147 infants; very low-certainty evidence). The studies did not report any data for major neurodevelopmental disability. No data are available for adverse effects; it is uncertain if the absence of adverse effects is because none occurred, or because they were not identified and recorded. The evidence is very uncertain about the effect of cycled light compared to dimmed light or near darkness on the likelihood of developing retinopathy of prematurity of any stage (RR 0.89, 95% CI 0.76 to 1.03; 3 studies, 307 infants; very low-certainty evidence), and severe retinopathy of prematurity of stage 3 or higher (RR 0.98, 95% CI 0.59 to 1.61; 4 studies, 454 infants; very low-certainty evidence). Cycled light compared to dimmed light or near darkness may have little to no effect on the duration of initial hospitalisation (MD -3.04, 95% CI -7.86 to 1.78; 5 studies, 550 infants; very low-certainty evidence), but the evidence is very uncertain. Cycled light versus continuous bright light (11 studies) No data are available on the following primary outcomes, as no studies reported them: growth at three and six months' corrected age, major neurodevelopmental disability, and adverse effects. It is uncertain if the absence of adverse effects is because none occurred or because they were not identified and recorded. No data are available on retinopathy of prematurity, as no studies reported it. Cycled light compared to continuous bright light may reduce the duration of initial hospitalisation, but the evidence is very uncertain (MD -9.86, 95% CI -10.09 to -9.63; 5 studies, 499 infants; very low-certainty evidence).

Authors' conclusions: Despite identifying 20 studies, we remain uncertain about the effect of CL compared to ND or CBL on all outcomes of interest in this review. In addition, a few critical outcomes were not reported by any of the included studies. The evidence remains uncertain about whether CL is the right choice in the NICU. The physician should always weigh the benefits and risks, based on the effects of the different options in the specific setting.

Trial registration: ClinicalTrials.gov NCT02146287 NCT01833091 NCT05230706 NCT02088359 NCT02688010 NCT05010252.

PubMed Disclaimer

Conflict of interest statement

IM has no interests to declare.

YTX has no interests to declare.

MB: no known conflicts of interest. MB is an Associate Editor with the Cochrane Neonatal Group but took no part in editorial acceptance or review of this manuscript.

Update of

References

References to studies included in this review

Arayici 2021 {published data only}
    1. Arayici S, Simsek GK, Uras N, Oncel MY, Canpolat FE, Oguz SS. Cycled lighting versus continuous near darkness in preterm infants: a randomized controlled trial. Klinische Pädiatrie 2022;234(02):74-80. [DOI: 10.1055/a-1554-5699] [PMID: ] - DOI - PubMed
Boo 2002 {published data only}
    1. Boo NY, Chee SC, Rohana J. Randomized controlled study of the effects of different durations of light exposure on weight gain by preterm infants in a neonatal intensive care unit. Acta Pædiatrica 2002;91(6):674-9. - PubMed
Brandon 2002 {published data only}
    1. Brandon DH, Holditch-Davis D, Belyea M, Tivnan DM. Factors affecting early neurobehavioral and sleep outcomes in preterm infants. In: Pediatric Academic Societies Meeting; 2003 May 3 - 6; Seatle (WA). http://www.abstracts2view.com/pasall/, 2003:2004.
    1. Brandon DH, Holditch-Davis D, Belyea M. Preterm infants born at less than 31 weeks' gestation have improved growth in cycled light compared with continuous near darkness. Journal of Pediatrics 2002;140(2):192-9. - PubMed
    1. Brandon DH, Holditch-Davis D, Winchester DM. Factors affecting early neurobehavioral and sleep outcomes in preterm infants. Infant Behavior & Development 2005;28(2):206-19.
    1. Brandon DH. The effect of cycled light versus continuous near darkness on growth and development of preterm infants born at less than 31 weeks gestation [PhD dissertation]. Chapel Hill (USA): University of North Carolina, 2000.
Brandon 2017 {published and unpublished data}
    1. Brandon DH, Silva SG, Park J, Malcolm W, Kamhawy H, Holditch-Davis D. Timing for the introduction of cycled light for extremely preterm infants: a randomized controlled trial. MIDIRS Midwifery Digest 2018;28(1):112. - PMC - PubMed
    1. Brandon DH, Silva SG, Park J, Malcolm W, Kamhawy H, Holditch-Davis D. Timing for the introduction of cycled light for extremely preterm infants: a randomized controlled trial. Research in Nursing & Health 2017;40(4):294-310. [DOI: 10.1002/nur.21797] [PMID: ] - DOI - PMC - PubMed
    1. Park J, Knafl G, Thoyre S, Brandon D. Factors associated with feeding progression in extremely preterm infants. Nursing Research 2015;64(3):159-67. [DOI: 10.1097/NNR.0000000000000093] [PMID: ] - DOI - PMC - PubMed
Esmaeilizadeh 2016 {published data only}IRCT2015060722583N1
    1. Esmaeilizadeh M, Shoja M, Shoja E, Shoja M, Nejat H, Oudi D. Comparing the effects of continuous and cyclical lightings on weight gain and length of hospital stay among preterm neonates. Modern Care Journal 2016;13(1):e8951. [DOI: 10.17795/modernc.8951] - DOI
    1. Shoja M, Shoja M, Esmaeilizadeh M, Shoja I. Investigation of the effect of simulated day/night model on weight gain and hospital discharge of preterm babies. Avicenna Journal of Phytomedicine 2015;5(Suppl 1):140.
Ezabadi 2020 {published data only}IRCT20171226038086N1
    1. Ezabadi AR, Dehghani K, Fallahzade H. Effect of the artificial night with facilitated tucking and artificial night alone on the physiological indices of premature infants. Iranian Journal of Neonatology 2020;11(2):91-8. [DOI: 10.22038/ijn.2020.42009.1696] - DOI
Farahani 2018 {published data only}IRCT2016073129141N1
    1. Farahani EA, Nourian M, Ahmadi F, Kazemian M. Comparing the effects of cycled and constant lighting on weight gain and length of stay in neonatal intensive care unit among premature neonates: a two-group randomized controlled clinical trial. Nursing and Midwifery Studies 2018;7:93-9. [DOI: 10.4103/nms.nms_7_17] - DOI
Guyer 2012 {published data only}
    1. Guyer C, Huber R, Fontijn J, Bucher HU, Nicolai H, Werner H, et al. Cycled light exposure reduces fussing and crying in very preterm infants. Pediatrics 2012;130(1):e145-51. - PubMed
Jung 2005 {published data only}
    1. Jung IS. Effects of cycled lighting on body weight, physiological variables and behavioral states in low birth weight infants. Taehan Kanho Hakhoe Chi 2005;35(1):143-53. [DOI: 10.4040/jkan.2005.35.1.143] [PMID: ] - DOI - PubMed
Lebel 2017 {published data only}
    1. Lebel V, Aita M, Johnston C, Héon M, Dupuis F. Effects of cycled lighting versus continuous near darkness on physiological stability and motor activity level in preterm infants. Advances in Neonatal Care 2017;17(4):281-91. [DOI: 10.1097/ANC.0000000000000372] [PMID: ] - DOI - PubMed
Lee 2016 {published data only}
    1. Lee KN, Seo BM, Moon DH, Jeon GW, Sin JB. Effect of lights-out at night time on body weight, physiological variables, and behavioral status in premature infants. Neonatal Medicine 2016;23(2):102-7. [DOI: 10.5385/nm.2016.23.2.102] - DOI
Mann 1986 {published data only}
    1. Mann NP, Haddow R, Stokes L, Goodley S, Rutter N. Effect of night and day on preterm infants in a newborn nursery: randomised trial. British Medical Journal 1986;293(6557):1265-7. - PMC - PubMed
Miller 1995 {published data only}
    1. Miller CL, White R, Whitman TL, O'Callaghan MF, Maxwell SE. The effects of cycled versus noncycled lighting on growth and development in preterm infants. Infant Behavior & Development 1995;18(1):87-95.
Mirmiran 2003 {published data only}
    1. Mirmiran M, Baldwin RB, Ariagno RL. Circadian and sleep development in preterm infants occurs independently from the influences of environmental lighting. Pediatric Research 2003;53(6):933-8. - PubMed
    1. Mirmiran M, Pedu VD, Baldwin RB, Saporito AG, Ariagno RL. Cycled light in the intermediate nursery: effects on development of preterm infants. In: Pediatric Academic Societies Meeting; 2001 April 28-May 1; Baltimore (MD). http://www.abstracts2view.com/pasall/, 2001:2045.
    1. Peddu V, Mirmiran M, Boeddiker M, Baldwin RB, Ariagno RL. Effect of light-dark (L/D) cycle on development of circadian rhythms in preterm infants. In: Pediatric Academic Societies Meeting; 2000 May 12-16; Boston, MA. http://www.abstracts2view.com/pasall/, 2000:2507.
Reyhani 2014 {published and unpublished data}
    1. Reyhani T, Aemmi SZ, Sannadgol V, Boskabadi H. The effect of creating an artificial night on physiological changes in preterm infants. International Journal of Pediatrics 2014;2(4.3):407-12. [DOI: 10.22038/ijp.2014.3621] - DOI
Rivkees 2004 {published data only}
    1. Rivkees SA, Mayes L, Jacobs H, Gross I. Rest-activity patterns of premature infants are regulated by cycled lighting. Pediatrics 2004;113(4):833-9. - PubMed
Sánchez‐Sánchez 2022 {published data only}
    1. NCT05230706. Light/​dark cycle promotes weight gain in preterm infants. https://clinicaltrials.gov/study/NCT05230706 (first posted 4 February 2022). [CLINICALTRIALS.GOV: NCT05230706]
    1. Sánchez-Sánchez M, García TL, Heredia D, Reséndiz I, Cruz L, Santiago J, et al. Effect of a light-darkness cycle on the body weight gain of preterm infants admitted to the neonatal intensive care unit. Scientific Reports 2022;12(1):17569. [DOI: 10.1038/s41598-022-22533-1] [PMID: ] - DOI - PMC - PubMed
Seiberth 1994 {published data only}
    1. Seiberth V, Linderkamp O, Knorz MC, Liesenhof H. A controlled clinical trial of light and retinopathy of prematurity. American Journal of Ophthalmology 1994;118(4):492-5. - PubMed
Tandircioglu 2021 {published data only}
    1. Tandircioglu UA, Guzoglu N, Gucuyener K, Aliefendioglu D. Influence of intensive care unit enlightenment on premature infants on functional brain maturation assessed by amplitude-integrated electroencephalograph. American Journal of Perinatology 2021;38(4):357-62. [DOI: 10.1055/s-0039-1697681] [PMID: ] - DOI - PubMed
Vásquez‐Ruiz 2014 {published data only}
    1. Vásquez-Ruiz S, Maya-Barrios JA, Torres-Narváez P, Vega-Martínez BR, Rojas-Granados A, Escobar C, et al. A light/dark cycle in the NICU accelerates body weight gain and shortens time to discharge in preterm infants. Early Human Development 2014;90(9):535-40. - PubMed

References to studies excluded from this review

Aita 2012 {published data only}
    1. Aita M, Johnston C, Goulet C, Oberlander TF, Snider L. Intervention minimizing preterm infants’ exposure to NICU light and noise. Clinical Nursing Research 2012;22(3):337–58. - PubMed
Aita 2019 {published data only}
    1. Aita M, Stremler R, Feeley N, Barrington K, Nuyt AM. Reducing NICU light and noise during kangaroo mother care: feasibility, acceptability and estimated effects on preterm infants' and mothers' outcomes. In: 7th World Congress on Pediatric Intensive and Critical Care; Istanbul, Turkey. https://journals.lww.com/pccmjournal/Fulltext/2014/05001/ABSTRACT_119__R..., 2014.
    1. Aita M, Stremler R, Feeley N, Nuyt AM, Lavallée A. Acceptability to nurses of reducing NICU light and noise levels during skin-to-skin care: A pilot study. Applied Nursing Research 2019;49:29-31. [DOI: 10.1016/j.apnr.2019.03.001] [PMID: ] - DOI - PubMed
Blackburn 1991 {published data only}
    1. Blackburn S, Patteson D. Effects of cycled light on activity state and cardiorespiratory function in preterm infants. Journal of Perinatal & Neonatal Nursing 1991;4(4):47-54. - PubMed
Braz 2006 {published data only}
    1. Braz RR, Moreira ME, Carvalho M, Lopes JM, Rodrigues MA, Cabral JA, et al. Effect of light reduction on the incidence of retinopathy of prematurity. Archives of Disease in Childhood Fetal and Neonatal Edition 2006;91(6):F443-4. - PMC - PubMed
Hirunpoem 2023 {published data only}TCTR20230802006
    1. Hirunpoem P, Waidab N, Wetprasit S. Effects of light- and sound-reduction incubator cover on duration of sleep in premature infants [ผลของการใช้ผ้าคลุมตู้ซับแสงเสียงต่อระยะเวลาการนอนหลับ ของทารกเกิดก่อนก าหนด: การวิจัยแบบสุ่มทดลอง]. Nursing Science Journal in Thailand 2023;41(3):64-78. [THAI CLINICAL TRIALS REGISTRY: TCTR20230802006] [URL: https://he02.tci-thaijo.org/index.php/ns/article/view/261699]
Hoogeveen 2004 {published data only}
    1. Hoogeveen E, Mirmiran M, Ariagno RL. Improved growth at four months in preterm infants receiving cycled light during newborn intermediate intensive care. In: Pediatric Academic Societies Meeting; 2004 May 1-4; San Francisco, CA. http://www.abstracts2view.com/pasall/, 2004:2503.
Kennedy 1997 {published data only}
    1. Kennedy KA, Ipson MA, Birch DG, Tyson JE, Anderson JL, Nusinowitz S, et al. Light reduction and the electroretinogram of preterm infants. Archives of Disease in Childhood Fetal & Neonatal Edition 1997;76(3):F168-73. [PMID: ] - PMC - PubMed
Kennedy 2001 {published data only}
    1. Kennedy KA, Fielder AR, Hardy RJ, Tung B, Gordon DC, Reynolds JD, LIGHT-ROP Cooperative Group. Reduced lighting does not improve medical outcomes in very low birth weight infants. Journal of Pediatrics 2001;139(4):527-31. [DOI: 10.1067/mpd.2001.117579] [PMID: ] - DOI - PubMed
Matsuishi 1998 {published data only}
    1. Matsuishi T, Ishibashi S, Kamiya Y, Shoji J, Yamashita Y, Fukuda S, et al. Early intervention for very-low-birth-weight infants. Brain & Development 1998;20(1):18-21. [DOI: 10.1016/s0387-7604(97)00087-9] [PMID: ] - DOI - PubMed
NCT02088359 {published data only}
    1. NCT02088359. Compare of effectiveness cycled light or near darkness on growth parameters in preterm infants. clinicaltrials.gov/study/NCT02088359 (first received 14 March 2014).
NCT02688010 {published data only}
    1. NCT02688010. Effect of reduced noise levels and cycled light on visual and neural development in preterm infants. clinicaltrials.gov/study/NCT02688010 (first received 23 February 2016).
Roy 1999 {published data only}
    1. Roy MS, Caramelli C, Orquin J, Uleckas J, Hardy P, Chemtob S. Effects of early reduced light exposure on central visual development in preterm infants. Acta Paediatrica 1999;88(4):459-61. [DOI: 10.1080/08035259950169873] [PMID: ] - DOI - PubMed
Valizadeh 2017 {published data only}
    1. Valizadeh S, Hosseini M, Jafarabadi MA, Mirnia K, Saeidi F, Jabraeeli M. Comparison of 2 methods of light reduction on preterm infants' sleep pattern in NICU: a randomized controlled trial. Crescent Journal of Medical and Biological Sciences 2017;4:211-6. [URL: http://www.cjmb.org/text.php?id=57]

References to studies awaiting assessment

Abdel 2021 {published data only}
    1. Abdel Hamid TA, Khairy Abdel Latif D, Bakeer A, Ibrahim AA, Amin Nasef K. Effect of light and noise on physiological parameters in a sample of preterm neonates in the neonatal intensive care of cairo university teaching hospital. Iranian Journal of Neonatology 2021;12(2):81-8. [DOI: 10.22038/ijn.2021.51741.1941] - DOI
Guyer 2009 {published data only}
    1. Guyer C, Fontijn J, Huber R, Bucher HU, Jenni OG. Effects of a 24h light-dark rhythm in neonatal care on sleep and crying pattern of preterm infants. Neuropsychobiology 2009;59(4):248L70004643. [PMID: 10.1159/000230666] - DOI
Kennaway 1996 {published data only}
    1. Kennaway DJ, Goble FC, Stamp GE. Factors influencing the development of melatonin rhythmicity in humans. Journal of Clinical Endocrinology and Metabolism 1996;81(4):1525-32. - PubMed
NCT05010252 {published data only}
    1. NCT05010252. The effect of cycled light on premature infants and mothers [The Effect of Cycled Light on the Physiological and Visual Development of Premature Infants and the Mother's Sleep and Quality of Life]. clinicaltrials.gov/study/NCT05010252 (first received 18 August 2021).

References to ongoing studies

ACTRN12618000371291 {published data only}ACTRN12618000371291
    1. ACTRN12618000371291. Cognitive improvement through early restoration of circadian rhythms in very preterm infants via environmental modification: the CIRCA DIEM study. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374490 (first received 12 March 2018).

Additional references

Arduini 1987
    1. Arduini D, Rizzo G, Parlati E, Dell'Acqua S, Romanini C, Mancuso S. Loss of circadian rhythms of fetal behaviour in a totally adrenalectomized pregnant woman. Gynecologic and Obstetric Investigation 1987;23(4):226-9. - PubMed
Bayley 1993
    1. Bayley N. Bayley Scales of Infant Development. 2nd edition. San Antonio (TX): The Psychological Corporation, 1993.
Bayley 2006
    1. Bayley N. Bayley Scales of Infant and Toddler Development. San Antonio (TX): Harcourt Assessment, 2006.
Begum 2006
    1. Begum EA, Bonno M, Obata M, Yamamoto H, Kawai M, Komada Y. Emergence of physiological rhythmicity in term and preterm neonates in a neonatal intensive care unit. Journal of Circadian Rhythms 2006;4:11. - PMC - PubMed
Blackburn 1998
    1. Blackburn S. Environmental impact of the NICU on developmental outcomes. Journal of Pediatric Nursing 1998;13(5):279-89. - PubMed
Borenstein 2013
    1. Borenstein M, Higgins JP. Meta-analysis and subgroups. Prevention Science 2013;14:134-43. [DOI: 10.1007/s11121-013-0377-7] - DOI - PubMed
Butt 2013
    1. Butt ML, McGrath JM, Samra HA, Gupta R. An integrative review of parent satisfaction with care provided in the neonatal intensive care unit. Journal of Obstetric, Gynecologic, and Neonatal Nursing 2013;42(1):105-20. [DOI: 10.1111/1552-6909.12002] - DOI - PubMed
Caba‐Flores 2023
    1. Caba-Flores MD, Martínez-Valenzuela C, Cárdenas-Tueme M, Camacho-Morales A. Micro problems with macro consequences: accumulation of persistent organic pollutants and microplastics in human breast milk and in human milk substitutes. Environmental Science and Pollution Research International 2023;30(42):95139-54. [DOI: 10.1007/s11356-023-29182-5] [PMID: ] - DOI - PubMed
Christina 2004
    1. Christina A, Merlin N, Vijaya C, Jayaprakash S, Murugesh N. Daily rhythm of nociception in rats. Journal of Circadian Rhythms 2004;2(1):2. - PMC - PubMed
Deeks 2022
    1. Deeks JJ, Higgins JP, Altman DG, editor(s). Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane, 2022. Available from https://training.cochrane.org/handbook/archive/v6.3/chapter-10.
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315(7109):629-34. [DOI: 10.1136/bmj.315.7109.629] - DOI - PMC - PubMed
EPOC 2017
    1. Cochrane Effective Practice and Organisation of Care (EPOC). Data extraction and management. EPOC resources for review authors, 2017. Available at epoc.cochrane.org/epoc-resources-review-authors (accessed 8 March 2024).
Glotzbach 1995
    1. Glotzbach SF, Edgar DM, Ariagno RL. Biological rhythmicity in preterm infants prior to discharge from neonatal intensive care. Pediatrics 1995;95(2):231-7. - PubMed
Gottfried 1985
    1. Gottfried A. Environmental neonatology. In: Gaiter JL, editors(s). Infant Stress Under Intensive Care. Baltimore: University Park Press, 1985:252-7.
GRADEpro GDT [Computer program]
    1. GRADEpro GDT. Version accessed 9 March 2024. Hamilton (ON): McMaster University and Evidence Prime, 2014. Available at gradepro.org.
Griffiths 1954
    1. Griffiths R. Abilities of Babies: a Study in Mental Measurement. New York (NY): McGraw-Hill Book Co. Inc., 1954.
Halberg 1969
    1. Halberg F. Chronobiology. Annual Review of Physiology 1969;31:675-725. - PubMed
Halberg 2003
    1. Halberg F, Cornélissen G, Katinas G, Syutkina EV, Sothern RB, Zaslavskaya R, et al. Transdisciplinary unifying implications of circadian findings in the 1950's. Journal of Circadian Rhythms 2003;1(1):2. - PMC - PubMed
Hao 1999
    1. Hao HP, Rivkees SA. The biological clock of very premature primate infants is responsive to light. National Academy of Sciences of the United States of America 1999;96(5):2426-9. - PMC - PubMed
Hazelhoff 2021
    1. Hazelhoff EM, Dudink J, Meijer JH, Kervezee L. Beginning to see the light: lessons learned from the development of the circadian system for optimizing light conditions in the neonatal intensive care unit. Frontiers in Neuroscience 2021;15:634034. [DOI: 10.3389/fnins.2021.634034] [PMID: ] - DOI - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). Cochrane Collaboration, 2011. Available from https://training.cochrane.org/handbook/archive/v5.1/.
Higgins 2023
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.4 (updated August 2023). Cochrane, 2023. Available from https://training.cochrane.org/handbook/archive/v6.4.
Hunt 2011
    1. Hunt KN. NICU: Environmental Effects of the Neonatal Intensive Care Unit on Infants and Caregivers. Carbondale (USA): Graduate School, Southern Illinois University, 2011. [URL: https://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1068&context=gs_rp]
Jacobs 2002
    1. Jacobs SE, Sokol J, Ohlsson A. The Newborn Individualized Developmental Care and Assessment program is not supported by meta-analyses of the data. Journal of Pediatrics 2002;140(6):699-706. - PubMed
Jacobs 2013
    1. Jacobs SE, Berg M, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No: CD003311. [DOI: 10.1002/14651858.CD003311.pub3] - DOI - PMC - PubMed
Jost 2017
    1. Jost K, Pramana I, Delgado-Eckert E, Kumar N, Datta AN, Frey U, et al. Dynamics and complexity of body temperature in preterm infants nursed in incubators. PLOS One 2017;12(4):e0176670. [DOI: 10.1371/journal.pone.0176670] [PMID: ] - DOI - PMC - PubMed
Keener 1988
    1. Keener MA, Zeanah CH, Andreas TF. Infant temperament, sleep organization, and night time parental interventions. Pediatrics 1988;81(6):762-71. - PubMed
Kennaway 1992
    1. Kennaway DJ, Stamp GE, Goble FC. Development of melatonin production in infants and the impact of prematurity. Journal of Clinical Endocrinology and Metabolism 1992;75(2):367-9. - PubMed
Kintraia 2005
    1. Kintraia PI, Zarnadze MG, Kintraia NP, Kashakashvili IG. Development of daily rhythmicity in heart rate and locomotor activity in the human fetus. Journal of Circadian Rhythms 2005;3(1):5. - PMC - PubMed
Lewis 2024
    1. Lewis P, Wild U, Pillow JJ, Foster RG, Erren TC. A systematic review of chronobiology for neonatal care units: What we know and what we should consider. Sleep Medicine Reviews 2024;73:101872. [DOI: 10.1016/j.smrv.2023.101872] - DOI - PubMed
Liberati 2009
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP A et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;339:b2700. [DOI: 10.1136/bmj.b2700] - DOI - PMC - PubMed
Lotas 1992
    1. Lotas MJ. Effects of light and sound in the neonatal intensive care unit environment on the low-birth-weight infant. NAACOGs' Clinical Issues in Perinatal and Women's Health Nursing 1992;3(1):34-44. - PubMed
Maguire 2008
    1. Maguire CM, Veen S, Sprij AJ, Le Cessie S, Wit JM, Walther FJ, Leiden Developmental Care Project. Effects of basic developmental care on neonatal morbidity, neuromotor development, and growth at term age of infants who were born at < 32 weeks. Pediatrics 2008;121(2):e239-45. - PubMed
Maguire 2009
    1. Maguire CM, Walther FJ, Zwieten PH, Le Cessie S, Wit JM, Veen S, Leiden Developmental Care Project. No change in developmental outcome with incubator covers and nesting for very preterm infants in a randomised controlled trial. Archives of Disease in Childhood Fetal and Neonatal Edition 2009;94:F92-7. - PubMed
Marshall 2018
    1. Marshall IJ, Noel-Storr AH, Kuiper J, Thomas J, Wallace BC. Machine learning for identifying randomized controlled trials: an evaluation and practitioner’s guide. Research Synthesis Methods 2018;9(4):602-14. [DOI: 10.1002/jrsm.1287] - DOI - PMC - PubMed
McGrath 2020
    1. McGrath S, Zhao X-F, Steele R, Thombs BD, Benedetti A, DEPRESsion Screening Data (DEPRESSD) Collaboration. Estimating the sample mean and standard deviation from commonly reported quantiles in meta-analysis. Statistical Methods in Medical Research 2020;29(9):2520-37. [DOI: 10.1177/0962280219889080] - DOI - PMC - PubMed
McGraw 1999
    1. McGraw K, Hoffmann R, Harker C, Herman JH. The development of circadian rhythms in a human infant. Sleep 1999;22(3):303-10. - PubMed
Mirmiran 1990
    1. Mirmiran M, Kok JH, Kleine MJ, Koppe JG, Overdijk J, Witting W. Circadian rhythms in preterm infants: a preliminary study. Early Human Development 1990;23(2):139-46. - PubMed
Mirmiran 1996
    1. Mirmiran M, Lunshof S. Perinatal development of human circadian rhythms. Progress in Brain Research 1996;111:217-26. - PubMed
Mirmiran 2000
    1. Mirmiran M, Ariagno RL. Influence of light in the NICU on the development of circadian rhythms in preterm infants. Seminars in Perinatology 2000;24(4):247-57. - PubMed
Morag 2019
    1. Morag I, Hendel Y, Karol D, Geva R, Tzipi S. Transition from nasogastric tube to oral feeding: the role of parental guided responsive feeding. Frontiers in Pediatrics 2019;7:190. [DOI: 10.3389/fped.2019.00190] [PMID: ] - DOI - PMC - PubMed
Noel‐Storr 2018
    1. Noel-Storr AH, the Project Transform team. Cochrane Crowd: new ways of working together to produce health evidence. Evidence Live 2018; 2018 18–20 June; Oxford, UK.
Ohlsson 2007
    1. Ohlsson A, Jacob S. Meta-regression can indicate if further NIDCAP studies are justified [Metaregression kan visa om fler NIDCAP-studier är motiverade]. Läkartidningen 2007;104(3):134-7. - PubMed
Ohlsson 2009
    1. Ohlsson A. NIDCAP: new controversial evidence for its effectiveness. Pediatrics 2009;124(4):1213-5. - PubMed
Ohlsson 2013
    1. Ohlsson A, Jacobs SE. NIDCAP: a systematic review and meta-analyses of randomized controlled trials. Pediatrics 2013;131(3):e881-93. - PubMed
Paranjpe 2005
    1. Paranjpe DA, Sharma VK. Evolution of temporal order in living organisms. Journal of Circadian Rhythms 2005;3(1):7. - PMC - PubMed
Patrick 1982
    1. Patrick J, Campbell K, Carmichael L, Natale R, Richardson B. Patterns of gross fetal body movements over 24-hour observation intervals during the last 10 weeks of pregnancy. American Journal of Obstetetrics and Gynecology 1982;142(4):363-71. - PubMed
Phelps 2001
    1. Phelps D, Watts J. Early light reduction for preventing retinopathy of prematurity in very low birth weight infants. Cochrane Database of Systematic Reviews 2001, Issue 1. Art. No: CD000122. [DOI: 10.1002/14651858.CD000122] - DOI - PubMed
Provasi 2021
    1. Provasi J, Blanc L, Carchon I. The importance of rhythmic stimulation for preterm infants in the NICU. Children 2021;8(8):660. [DOI: 10.3390/children8080660] [PMID: ] - DOI - PMC - PubMed
Rea 2008
    1. Rea MS, Bierman A, Figueiro MG, Bullough JD. A new approach to understanding the impact of circadian disruption on human health. Journal of Circadian Rhythms 2008;6:7. - PMC - PubMed
Rea 2010
    1. Rea MS, Figueiro MG, Bierman A, Bullough JD. Circadian light. Journal of Circadian Rhythms 2010;8:2. - PMC - PubMed
Refinetti 2003
    1. Refinetti R. Journal of Circadian Rhythms: 21st-century publishing for 21st century science. Journal of Circadian Rhythms 2003;1(1):1. - PMC - PubMed
RevMan 2024 [Computer program]
    1. Review Manager (RevMan). Version 8.8.0. The Cochrane Collaboration, 2024. Available at revman.cochrane.org.
Rivkees 2000
    1. Rivkees SA, Halo H. Developing circadian rhythmicity. Seminars in Perinatology 2000;24:232-42. - PubMed
Rivkees 2003
    1. Rivkees SA. Developing circadian rhythmicity in infants. Pediatrics 2003;112(2):373-81. - PubMed
Rivkees 2004a
    1. Rivkees SA. Emergence and influences of circadian rhythmicity in infants. Clinics in Perinatology 2004;31(2):217-28. - PubMed
Schünemann 2013
    1. Schünemann H, Brożek J, Guyatt G, Oxman A, editor(s). GRADE Handbook for Grading Quality of Evidence and Strength of Recommendations. (Updated October 2013). GRADE Working Group, 2013. Available from gdt.guidelinedevelopment.org/app/handbook/handbook.html.
Seron‐Ferre 2001
    1. Seron-Ferre M, Torres-Farfan C, Forcelledo ML, Valenzuela GJ. The development of circadian rhythms in the fetus and neonate. Seminars in Perinatology 2001;25(6):363-70. - PubMed
Stetson 1986
    1. Stetson MH, Elliott JA, Goldman BD. Maternal transfer of photoperiodic information influences the photoperiodic responses of prepubertal Djungarian hamsters (Phodopus sungorus sungorus). Biology of Reproduction 1986;34(4):664-9. - PubMed
Sukumaran 2010
    1. Sukumaran S, Almon RR, DuBois DC, Jusko WJ. Circadian rhythms in gene expression: relationship to physiology, disease, drug disposition and drug action. Advances Drug Delivery Reviews 2010;62(9-10):904-17. - PMC - PubMed
Suwaydi 2023
    1. Suwaydi MA, Lai CT, Rea A, Gridneva Z, Perrella SL, Wlodek ME, et al. Circadian variation in human milk hormones and macronutrients. Nutrients 2023;15(17):3729. [DOI: 10.3390/nu15173729] [PMID: ] - DOI - PMC - PubMed
Symington 2006
    1. Symington A, Pinelli J. Developmental care for promoting development and preventing morbidity in preterm infants. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No: CD001814. [DOI: 10.1002/14651858.CD001814.pub2] - DOI - PMC - PubMed
Thoman 1989a
    1. Thoman EB, Ingersoll EW. The human nature of the youngest human: prematurely born babies. Seminars in Perinatology 1989;13(6):482-94. - PubMed
Thoman 1989b
    1. Thoman EB, Whitney MP. Sleep states of infants monitored in the home: individual differences, developmental trends, and origin of diurnal cyclicity. Infant Behavior & Development 1989;12(1):59-75.
Thomas 2017
    1. Thomas J, Noel-Storr AH, Marshall I, Wallace B, McDonald S, Mavergames C, et al, Living Systematic Review Network. Living systematic reviews: 2. combining human and machine effort. Journal of Clinical Epidemiology 2017;91:31-7. [DOI: 10.1016/j.jclinepi.2017.08.011] - DOI - PubMed
Van Gilst 2023
    1. Van Gilst D, Puchkina AV, Roelants JA, Kervezee L, Dudink J, Reiss IK, et al. Effects of the neonatal intensive care environment on circadian health and development of preterm infants. Frontiers in Physiology 2023;14:1243162. [DOI: 10.3389/fphys.2023.1243162] [PMID: ] - DOI - PMC - PubMed
White 2007
    1. White RD. Recommended standards for newborn ICU design: report of the Seventh Census Conference on Newborn ICU Design Committee to Establish Recommended Standards for Newborn ICU Design, 2007. www.nd.edu/~nicudes/index.html (accessed 29 July 2013).

References to other published versions of this review

Morag 2011
    1. Morag I, Ohlsson A. Cycled light in the intensive care unit for preterm and low birth weight infants. Cochrane Database of Systematic Reviews 2011, Issue 1. Art. No: CD006982. [DOI: 10.1002/14651858.CD006982] - DOI - PubMed
Morag 2013
    1. Morag I, Ohlsson A. Cycled light in the intensive care unit for preterm and low birth weight infants. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No: CD006982. [DOI: 10.1002/14651858.CD006982.pub2] - DOI - PubMed
Morag 2016
    1. Morag I, Ohlsson A. Cycled light in the intensive care unit for preterm and low birth weight infants. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No: CD006982. [DOI: 10.1002/14651858.CD006982.pub4] - DOI - PMC - PubMed

MeSH terms

Associated data

LinkOut - more resources