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
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
Current version onlyNeonatal 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
| Outcome | Effect | Evidence | Status / 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] | NR | High |
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] | NR | High |
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] | NR | High |
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] | NR | Moderate Downgraded: indirectness |
Mean birthweight (g)№ of participants: 9551(19 RCTs) Neonatal and child outcomes: corticosteroids vs placebo or no treatment | no estimate extracted | NR | High |
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] | NR | Moderate 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal death Maternal outcomes: corticosteroids vs placebo or no treatment | RR 1.19 [0.36, 3.89] | NR | Moderate Downgraded: imprecision |
Chorioamnionitis№ of participants: 8374(15 RCTs) Maternal outcomes: corticosteroids vs placebo or no treatment | RR 0.86 [0.69, 1.08] | NR | Moderate Downgraded: imprecision |
Endometritis№ of participants: 6764(10 RCTs) Maternal outcomes: corticosteroids vs placebo or no treatment | RR 1.14 [0.82, 1.58] | NR | Moderate Downgraded: imprecision |
Corticosteroids versus placebo or no treatment
Population: pregnant women at high risk of preterm birth receiving a corticosteroid or placebo/no treatment; women with singleton and multiple pregnancy and intact and ruptured membranes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Maternal death Corticosteroids vs placebo or no treatment | RR 0.98 [0.06, 15.5] | 5 studies · 3392 participants | Moderate Downgraded: imprecision |
Chorioamnionitis Corticosteroids vs placebo or no treatment | RR 0.83 [0.66, 1.06] | 15 studies · 5546 participants | Moderate Downgraded: imprecision, inconsistency |
Endometritis (infections) Corticosteroids vs placebo or no treatment | RR 1.2 [0.87, 1.63] | 10 studies · 4030 participants | Moderate Downgraded: imprecision, inconsistency |
Perinatal deaths Corticosteroids vs placebo or no treatment | RR 0.72 [0.58, 0.89] | 15 studies · 6729 participants | Moderate |
Respiratory distress syndrome Corticosteroids vs placebo or no treatment | RR 0.66 [0.56, 0.77] | 28 studies · 7764 participants | Moderate |
Intraventricular haemorrhage Corticosteroids vs placebo or no treatment | RR 0.55 [0.4, 0.76] | 16 studies · 6093 participants | Moderate |
Mean birthweight (grams) (less is worse) Corticosteroids vs placebo or no treatment | no estimate extracted | 16 studies · 6182 participants | Moderate Downgraded: imprecision |