Limitations
cot
RECRUITMENT, SENSITIVITY, SECONDARY, SEPARATION, SUDDEN INFANT DEATH SYNDROME, EVENTS
There was <5% missing data for primary and secondary outcomes, some missing at random and some not. The sequence effect in the events model is thought to be due to patient characteristics. Sensitivity analysis showed results are robust and confirm Condition B as superior.Our position intervention combined both infant and cot position, as these typically occur together and their separation would complicate crossover design. Further study is required to evaluate any separate contributions. Prone positioning improves quiet sleep, which is known to positively impact frequency of respiratory events.Additionally, infants undertook interventions for the entire 24‐h period. Developmental implications of this approach require further evaluation, and additional studies could evaluate if interventions during feed times only might preserve this effect. This study targeted ‘stable, growing’ spontaneously breathing preterm infants (mean gestation of 34.6 weeks). Results may not, therefore, be applicable to younger infants or those receiving additional respiratory supports. These findings may also conflict with recommendations to promote supine positioning as infants approach discharge to reduce the incidence of Sudden Infant Death Syndrome and must therefore consider individual infant factors and disposition planning.Our proposed sample size was not achieved for a number of reasons, most importantly premature cessation of the study to the Covid‐19 pandemic. Recruitment was additionally impacted by unexpectedly short eligibility windows between cessation of respiratory support and oral‐feed introduction. We observed, however, smaller between‐ and within‐subject variances and an increased percent reduction in number of events than predicted by the pilot (50% compared with 40% from the pilot). Post hoc power analyses showed an 