The influence of massage on neonatal hyperbilirubinemia: a meta-analysis of randomized controlled trials

Introduction: The efficacy of massage to treat neonatal hyperbilirubinemia remains controversial. We conducted a systematic review and meta-analysis to explore the influence of massage on the neonatal hyperbilirubinemia.Methods: We search PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases through November 2017 for randomized controlled trials (RCTs) assessing the effect of massage on neonatal hyperbilirubinemia. This meta-analysis is performed using the random-effect model.Results: Six RCTs involving 357 patients are included in the meta-analysis. Overall, compared with the control group in neonatal hyperbilirubinemia, massage therapy is associated with substantially reduced serum bilirubin level within 4d (mean difference (MD)=-2.31; 95% CI=-2.92 to -1.70; p<.00001) and transcutaneous bilirubin level within 4d for neonatal hyperbilirubinemia (MD=-1.97; 95% CI=-2.55 to -1.39; p<.00001), but results no remarkable impact on serum bilirubin level on 2d (MD=-0.82; 95% CI=-2.16-0.52; p=.23), transcutaneous bilirubin level on 2d (MD=-0.17; 95% CI=-1.34 to 1.00; p=.77), frequency of defecation daily on 2d (MD=0.57; 95% CI=-0.03 to 1.16; p=.06), and frequency of defecation daily within 4d (MD=0.83; 95% CI=-0.11 to 1.76; p=.08).Conclusions: Massage therapy can significantly reduce serum bilirubin level and transcutaneous bilirubin level within 4d, but demonstrates no influence on serum bilirubin level and transcutaneous bilirubin level on 2d, frequency of defecation daily on 2 and 4d for neonatal hyperbilirubinemia.