Mega Hasanul Huda, Khatijah Lim Abdullah, Herry Susanto, Joseph Kondwani Banda, Yeni Rustina, Hasriza Eka Putra, Niken Angelia, Novardian, Robiyatul Adawiyah, Rizkya Wimahavinda Kardono, Ita Daryanti Saragih, Ika Saptarini, Neni Fidya Santi, Faizul Hasan
Aim: To compare complementary interventions for improving weight gain in preterm infants via network meta-analysis (NMA). Methods: We conducted a systematic review and NMA across six databases, including randomized controlled trials (RCTs). Two reviewers independently extracted data and assessed bias. Analyses used a Bayesian framework in GeMTC software, with effects reported as standardizes mean differences (SMDs). Confidence In Network Meta-Analysis evaluated inconsistency, ranking and evidence certainty. Results: In total, 61 RCTs (n = 5858 infants) were analysed. Tactile kinesthetic stimulation showed greatest weight gain improvement (SMD 8.9, 95% CI 0.8–17). Multisensory stimulation (SMD 7.0, 6.2–7.9) and its combination with music therapy (SMD 7.9, 6.6–9.1) were also effective. Other beneficial interventions included kinesthetic stimulation (SMD 1.3, 0.091–2.5), massage (SMD 0.70, 0.39–1.0), and massage plus tactile stimulation (SMD 0.94, 0.044–1.9). Oral stimulation reduced hospitalization duration (SMD −0.49, −0.88 to −0.098). Conclusions: Tactile kinesthetic, multisensory stimulation and massage combinations significantly enhance preterm infant weight gain. These interventions should be considered in neonatal care protocols to optimize growth outcomes. Trial Registration: The PROSPERO registration number is CRD42024557428. © 2026 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Faculty of Nursing, Universitas Indonesia, Depok, Indonesia; Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency, Bogor, Indonesia; Departement of Nursing, School of Medical and Life Science, Sunway University, Selangor, Malaysia; Faculty of Nursing, Universitas Islam Sultan Agung, Semarang, Indonesia; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Faculty of Medicine, Universitas Indonesia, Depok, Indonesia; Faculty of Health Sciences, Universitas Esa Unggul, Jakarta, Indonesia; Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Universitas Indonesia Hospital, Depok, Indonesia; Postdoctoral Fellow, College of Information Sciences and Technology, Pennsylvania State University, PA, United States; Nursing Department, Faculty of Medicine, Universitas Negeri Malang, Malang, Indonesia; Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
