Preterm birth (= birth of an infant before the completion of the 37th week of pregnancy) is one of the main determinants of the risk of developing a disease later in life (Soon 2012). In addition to the long-term physical and psychological effects, premature births also cause higher economic costs (Beck et al. 2010). Length of stay in neonatal intensive care units is one of the most important clinical outcomes used as a proxy to study the effectiveness of interventions in infants. This length of stay appears to correlate with length of pregnancy and birth weight: The shorter the pregnancy, the longer the hospital stay and the higher the risk of morbidity (Bakewell-Sachs et al. 2009).
Already in 2013, Cerritelli and colleagues provided preliminary results on a positive effect of OMT in newborns compared to routine medical care in terms of reduction of hospitalisation days and costs (Cerritelli et al. 2013). This preliminary evidence was replicated two years later in another randomised trial with a larger sample size (n=695). A significant reduction in hospital stay of 3.9 days was observed after the use of OMT in preterm infants. Furthermore, there were also significant cost reductions compared to standard treatment (Cerritelli et al. 2015). Another study by Pizzolorusso et al. was also able to show that OMT in preterm infants led to a significant reduction in hospital stay (-2.03 days) (Pizzolorusso et al. 2014). The methodological quality of the above-mentioned studies can also be classified as good.
Osteopathic manipulative therapy also has a positive influence on gastrointestinal function in preterm infants and on the length of stay in hospital. This was observed in a prospective, non-randomised cohort study of 350 consecutive newborns. Those preterm infants (n=162) who received OMT in addition to standard treatment showed a 55% reduction in gastrointestinal symptoms and a reduction in hospital stay of more than 75% (Pizzolorusso et al. 2014).
The available data from studies on preterm infants thus provide robust evidence that OMT is effective in reducing the length of hospital stay of treated infants and is also efficient in reducing costs. In the future, cost-effectiveness analyses should therefore also be included in new study designs in order to establish OMT in neonatal health services (Bagagiolo et al. 2016).
Bagagiolo D, Didio A, Sbarbaro M, et al. Osteopathic Manipulative Treatment in Pediatric and Neonatal Patients and Disorders: Clinical Considerations and Updated Review of the Existing Literature. Am J Perinatol. 2016;33(11):1050-1054
Bakewell-Sachs S, Medoff-Cooper B, Escobar GJ, et al. Infant functional status: the timing of physiologic maturation of premature infants. Pediatrics. 2009;123(5):e878-e886
Beck S, Wojdyla D, Say L, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88:31-38
Cerritelli F, Pizzolorusso G, Ciardelli F, et al. Effect of osteopathic manipulative treatment on length of stay in a population of preterm infants: A randomized controlled trial. BMC Pediatr. 2013;13(1)
Cerritelli F, Pizzolorusso G, Renzetti C, et al. A multicenter, randomized, controlled trial of osteopathic manipulative treatment on preterms. PLoS One. 2015;10(5):1-12
Pizzolorusso G, Cerritelli F, Accorsi A, et al. The effect of optimally timed osteopathic manipulative treatment on length of hospital stay in moderate and late preterm infants: Results from a RCT. Evidence-based Complement Altern Med. 2014;2014
Soon BT. The global action report on preterm birth. Geneva World Heal Organ. Published online 2012