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What do systematic reviews say?

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Evidence found and GRADE certainty

49 questions · 51 findings · 8 reviews · Neonatal

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No studies found 0 · 0%GRADE not reported 4 · 7.8%Very low 8 · 15.7%Low 10 · 19.6%Moderate 21 · 41.2%High 8 · 15.7%

Early inhaled steroids (< 2 weeks) vs placebo (among all randomised)

Oxygen requirement at 36 weeks' postmenstrual age · very low birth weight preterm neonates

Early inhaled steroids (< 2 weeks) showed no clear difference in CLD at 36 weeks' PMA oxygen dependency at 36 weeks' PMA compared with placebo (among all randomised) (moderate certainty).

1 finding from 1 review

Early inhaled steroids (< 2 weeks) vs placebo (among all randomised)

Death by, or CLD at, 36 weeks' PMA Death or oxygen dependency at 36 weeks' PMA · very low birth weight preterm neonates

Early inhaled steroids (< 2 weeks) probably leads to lower death by, or CLD at, 36 weeks' PMA Death or oxygen dependency at 36… compared with placebo (among all randomised) (moderate certainty).

1 finding from 1 review

Early systemic postnatal corticosteroids vs placebo or no treatment

Mortality Mortality at latest · preventing bronchopulmonary dysplasia in preterm infants

Early systemic postnatal corticosteroids showed no clear difference in mortality at latest reported age compared with placebo or no treatment (high certainty).

1 finding from 1 review

Early systemic postnatal corticosteroids vs placebo or no treatment

BPD (36 weeks' PMA) · preventing bronchopulmonary dysplasia in preterm infants

Early systemic postnatal corticosteroids probably leads to lower BPD (36 weeks' PMA) compared with placebo or no treatment (moderate certainty).

1 finding from 1 review

Early systemic postnatal corticosteroids vs placebo or no treatment

Death or bronchopulmonary dysplasia at 36 weeks PMA · preventing bronchopulmonary dysplasia in preterm infants

Early systemic postnatal corticosteroids leads to lower mortality or BPD at 36 weeks' PMA compared with placebo or no treatment (high certainty).

1 finding from 1 review

Early systemic postnatal corticosteroids vs placebo or no treatment

Gastrointestinal perforation during primary hospitalisation · preventing bronchopulmonary dysplasia in preterm infants

Early systemic postnatal corticosteroids leads to higher gastrointestinal perforation during primary hospitalisation compared with placebo or no treatment (high certainty).

1 finding from 1 review

Early systemic postnatal corticosteroids vs placebo or no treatment

Cerebral palsy · preventing bronchopulmonary dysplasia in preterm infants

Early systemic postnatal corticosteroids leads to higher cerebral palsy at latest reported age compared with placebo or no treatment (high certainty).

1 finding from 1 review

Early systemic postnatal corticosteroids vs placebo or no treatment

Death or cerebral palsy · preventing bronchopulmonary dysplasia in preterm infants

Early systemic postnatal corticosteroids showed no clear difference in mortality or cerebral palsy at latest reported age compared with placebo or no treatment (high certainty).

1 finding from 1 review

Systemic corticosteroids vs placebo or control

Mortality Mortality at latest · preterm infants with chronic lung disease

Systemic corticosteroids (dexamethasone or hydrocortisone) leads to lower mortality at latest reported age compared with control (placebo or nothing) (high certainty).

1 finding from 1 review

Systemic corticosteroids vs placebo or control

Bronchopulmonary dysplasia/chronic lung disease · preterm infants with chronic lung disease

Systemic corticosteroids (dexamethasone or hydrocortisone) probably leads to lower BPD at 36 weeks' PMA compared with control (placebo or nothing) (moderate certainty).

1 finding from 1 review

Systemic corticosteroids vs placebo or control

Death or bronchopulmonary dysplasia at 36 weeks PMA · preterm infants with chronic lung disease

Systemic corticosteroids (dexamethasone or hydrocortisone) probably leads to lower mortality or BPD at 36 weeks' PMA compared with control (placebo or nothing) (moderate certainty).

1 finding from 1 review

Systemic corticosteroids vs placebo or control

Cerebral palsy · preterm infants with chronic lung disease

Systemic corticosteroids (dexamethasone or hydrocortisone) showed no clear difference in cerebral palsy ‐ at latest reported age compared with control (placebo or nothing) (high certainty).

1 finding from 1 review

Systemic corticosteroids vs placebo or control

Death or cerebral palsy · preterm infants with chronic lung disease

Systemic corticosteroids (dexamethasone or hydrocortisone) showed no clear difference in mortality or cerebral palsy ‐ at latest reported age compared with control (placebo or nothing) (high certainty).

1 finding from 1 review

Early inhaled steroids (< 2 weeks) vs placebo (among survivors)

CLD at 36 weeks' PMA · very low birth weight preterm neonates

Early inhaled steroid (< 2 weeks) probably leads to lower CLD at 36 weeks' PMA compared with placebo (among survivors) (moderate certainty).

1 finding from 1 review