Cochrane · systematic review · CD004454

Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth

McGoldrick, E, Stewart, F, Parker, R, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Pregnancy and Childbirth2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
9
current version
GRADE rated
9
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 0 · 0%Moderate 5 · 55.6%High 4 · 44.4%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

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Neonatal and child outcomes: corticosteroids compared to placebo or no treatment for accelerating fetal lung maturation for women at risk of preterm birth

Population: infants born of women at risk of preterm birth
6 questions
OutcomeEffectEvidenceStatus / GRADE
Perinatal death (composite of fetal death (in utero death) and neonatal death)№ of participants: 9833(14 RCTs)
Neonatal and child outcomes: corticosteroids vs placebo or no treatment
RR 0.85 [0.77, 0.93]NRHigh
Neonatal death (infants born with signs of life who die within the first 28 days)№ of participants: 10,609(22 RCTs)
Neonatal and child outcomes: corticosteroids vs placebo or no treatment
RR 0.78 [0.7, 0.87]NRHigh
Respiratory distress syndrome№ of participants: 11,183(26 RCTs)
Neonatal and child outcomes: corticosteroids vs placebo or no treatment
RR 0.71 [0.65, 0.78]NRHigh
Intraventricular haemorrhage (IVH)№ of participants: 8475(12 RCTs)
Neonatal and child outcomes: corticosteroids vs placebo or no treatment
RR 0.58 [0.45, 0.75]NRModerate
Downgraded: indirectness
Mean birthweight (g)№ of participants: 9551(19 RCTs)
Neonatal and child outcomes: corticosteroids vs placebo or no treatment
no estimate extractedNRHigh
Developmental delay in childhood№ of participants: 600 (3 RCTs). Age at
Neonatal and child outcomes: corticosteroids vs placebo or no treatment
RR 0.51 [0.27, 0.97]NRModerate
Downgraded: risk of bias, indirectness

Maternal outcomes: corticosteroids compared to placebo or no treatment for accelerating fetal lung maturation for women at risk of preterm birth

Population: women at risk of preterm birth
3 questions
OutcomeEffectEvidenceStatus / GRADE
Maternal death
Maternal outcomes: corticosteroids vs placebo or no treatment
RR 1.19 [0.36, 3.89]NRModerate
Downgraded: imprecision
Chorioamnionitis№ of participants: 8374(15 RCTs)
Maternal outcomes: corticosteroids vs placebo or no treatment
RR 0.86 [0.69, 1.08]NRModerate
Downgraded: imprecision
Endometritis№ of participants: 6764(10 RCTs)
Maternal outcomes: corticosteroids vs placebo or no treatment
RR 1.14 [0.82, 1.58]NRModerate
Downgraded: imprecision