Matsushita FY, et al. - Among critically ill neonates in the ICU, fluid overload (FO) was identified to be related to higher mortality, acute kidney injury (AKI), and requirement for mechanical ventilation.

• This systematic review and meta-analysis involved 17 eligible observational studies (n=4772) to investigate the link between FO and mortality in critically ill neonates.

• Higher mortality was observed in relation to FO (OR, 4.95), and a lower percentage of FO was detected in survivors vs nonsurvivors (WMD, − 4.33).

• Lower FO was found in neonates who did not develop AKI vs AKI patients (WMD, − 2.29).

• There was a lower fluid balance in neonates who did not need mechanical ventilation on postnatal day 7 (WMD, − 1.54).