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What do systematic reviews say?

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Evidence found and GRADE certainty

33 questions · 34 findings · 5 reviews · Neonatal · Headline outcomes only

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No studies found 0 · 0%GRADE not reported 0 · 0%Very low 1 · 2.9%Low 7 · 20.6%Moderate 18 · 52.9%High 8 · 23.5%

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 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

Inhaled steroids vs systemic corticosteroids

BPD or death at 36 weeks' postmenstrual age№ of participants: 0 (0 RCTs) · preterm infants with respiratory distress for initial respiratory support

Inhaled steroids showed no clear difference in death or BPD at 36 weeks' postmenstrual age among all randomised compared with systemic corticosteroids (moderate certainty).

1 finding from 1 review

Inhaled steroids vs systemic corticosteroids

Death or BPD (28 days) · preterm infants with respiratory distress for initial respiratory support

Inhaled steroids showed no clear difference in death or BPD at 28 days compared with systemic corticosteroids (low certainty).

1 finding from 1 review

Inhaled steroids vs systemic corticosteroids

Bronchopulmonary dysplasia/chronic lung disease · preterm infants with respiratory distress for initial respiratory support

Inhaled steroids showed no clear difference in BPD at 36 weeks' postmenstrual age compared with systemic corticosteroids (moderate certainty).

1 finding from 1 review

Inhaled steroids vs systemic steroids

Death or bronchopulmonary dysplasia at 36 weeks PMA · Neonates with developing BPD

Inhaled steroids showed no clear difference in death or BPD at 36 weeks' postmenstrual age compared with systemic steroids (moderate certainty).

2 findings from 1 review

Inhaled steroids vs systemic steroids

Diastolic blood pressure > 95th percentile at 7 years · Neonates with developing BPD

Inhaled steroids probably leads to lower diastolic blood pressure > 95th percentile at 7 years compared with systemic steroids (moderate certainty).

1 finding from 1 review