Prophylactic CPAP for Preterm Infants

(PLaNT2 Trial)

The PLaNT 2 study will test whether giving breathing support soon after birth can help late preterm babies born by cesarean section (C-section). The goal is to lower breathing problems and the need for admission to the neonatal intensive care unit (NICU).

Late preterm babies are born a few weeks before their due date. They have a higher risk of breathing problems after birth, especially after a C-section. A recent international pilot study showed promising results with early breathing support in these babies. A larger study is now needed to find out if this approach works.

Continuous positive airway pressure (CPAP) is a common form of breathing support for newborns. It provides gentle air pressure through a mask or nasal prongs. CPAP is usually given after a baby develops breathing problems. PLaNT 2 will test giving CPAP shortly after birth, before breathing problems develop.

The study will include 300 babies born by C-section at 35 to 36 weeks of pregnancy. Babies who are breathing on their own within 5 minutes after birth may take part. The study will randomly assign babies to one of two groups:

* One group will receive 20 minutes of CPAP shortly after birth.

* The other group will receive the hospital's usual care. Babies in either group can receive CPAP or other breathing support later if they need it.

The main question is whether early CPAP lowers the number of babies admitted to the NICU for breathing support. Researchers will also look at the need for breathing support after birth. They will study parental stress, bonding between mothers and babies, and exclusive breastfeeding.

If this approach works, it could lower breathing problems and unnecessary NICU admissions. This could allow more babies to stay with their families. CPAP is already available in many hospitals, so this approach could be used in different health care settings around the world. It may also support early bonding, breastfeeding, and family-centered newborn care.