Cochrane · systematic review · CD006764
Different corticosteroids and regimens for accelerating fetal lung maturation for babies at risk of preterm birth
Williams, MJ, Ramson, JA, Brownfoot, FC · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 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
30
current version
GRADE rated
25
No studies
5
Included studies
NR
No studies 5 · 16.7%Ungraded 0 · 0%Very low 12 · 40%Low 4 · 13.3%Moderate 8 · 26.7%High 1 · 3.3%
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
Dexamethasone compared to betamethasone – maternal outcomes
Population: women at risk of preterm birth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death Dexamethasone vs betamethasone – maternal outcomes | no estimate extracted | NR | No studies |
Chorioamnionitis Dexamethasone vs betamethasone – maternal outcomes | RR 0.71 [0.48, 1.06] | 1 study · 1346 participants | Moderate Downgraded: risk of bias, imprecision |
Puerperal sepsis Dexamethasone vs betamethasone – maternal outcomes | no estimate extracted | NR | No studies |
Maternal adverse effects of therapy Dexamethasone vs betamethasone – maternal outcomes | RR 0.63 [0.35, 1.13] | 2 studies · 1705 participants | Moderate Downgraded: risk of bias, imprecision |
Dexamethasone compared to betamethasone – fetal/neonatal outcomes
Population: women at risk of preterm birth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any known death after randomisation (fetal, neonatal, child, child as adult) Dexamethasone vs betamethasone – fetal/neonatal outcomes | RR 1.03 [0.66, 1.63] | 5 studies · 2105 participants | Moderate Downgraded: imprecision |
Respiratory distress syndrome Dexamethasone vs betamethasone – fetal/neonatal outcomes | RR 1.06 [0.91, 1.22] | 5 studies · 2105 participants | High |
Intraventricular haemorrhage Dexamethasone vs betamethasone – fetal/neonatal outcomes | RR 0.71 [0.28, 1.81] | 4 studies · 1901 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Chronic lung disease Dexamethasone vs betamethasone – fetal/neonatal outcomes | RR 0.92 [0.64, 1.34] | 1 study · 1509 participants | Moderate Downgraded: risk of bias, imprecision |
Necrotising enterocolitis Dexamethasone vs betamethasone – fetal/neonatal outcomes | RR 5.08 [0.25, 105.15] | 2 studies · 441 participants | Low Downgraded: imprecision |
Dexamethasone compared to betamethasone – child outcomes
Population: women at risk of preterm birth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Neurodevelopmental disability at Dexamethasone vs betamethasone – child outcomes | RR 1.02 [0.85, 1.22] | 2 studies · 1151 participants | Moderate Downgraded: risk of bias |
Visual impairment Dexamethasone vs betamethasone – child outcomes | RR 0.33 [0.01, 8.15] | 1 study · 1227 participants | Low Downgraded: risk of bias, imprecision |
Hearing impairment Dexamethasone vs betamethasone – child outcomes | RR 1.16 [0.63, 2.16] | 1 study · 1227 participants | Moderate Downgraded: risk of bias, imprecision |
Developmental delay –motor (mild, moderate or severe) Dexamethasone vs betamethasone – child outcomes | RR 0.89 [0.66, 1.2] | 1 study · 1166 participants | Moderate Downgraded: risk of bias, imprecision |
Intellectual impairment: developmental delay – cognitive or language (mild, moderate or severe) Dexamethasone vs betamethasone – child outcomes | RR 0.97 [0.79, 1.2] | 1 study · 1161 participants | Moderate Downgraded: risk of bias |
Cerebral palsy Dexamethasone vs betamethasone – child outcomes | RR 2.5 [0.97, 6.39] | 1 study · 1223 participants | Low Downgraded: risk of bias, imprecision |
Dexamethasone: oral compared to intramuscular – fetal/neonatal outcomes
Population: women at risk of preterm birth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any known death after randomisation (fetal, neonatal, child, child as adult) Dexamethasone: oral vs intramuscular – fetal/neonatal outcomes | RR 1.48 [0.45, 4.9] | 1 study · 183 participants | Very low Downgraded: risk of bias, imprecision |
Respiratory distress syndrome Dexamethasone: oral vs intramuscular – fetal/neonatal outcomes | RR 1.15 [0.75, 1.77] | 1 study · 183 participants | Very low Downgraded: risk of bias, imprecision |
Intraventricular haemorrhage Dexamethasone: oral vs intramuscular – fetal/neonatal outcomes | RR 4.24 [0.96, 18.83] | 1 study · 183 participants | Very low Downgraded: risk of bias, imprecision |
Necrotising enterocolitis Dexamethasone: oral vs intramuscular – fetal/neonatal outcomes | RR 5.09 [0.63, 41.45] | 1 study · 183 participants | Very low Downgraded: risk of bias, imprecision |
Chronic lung disease Dexamethasone: oral vs intramuscular – fetal/neonatal outcomes | no estimate extracted | NR | No studies |
Betamethasone acetate plus phosphate compared to betamethasone phosphate – fetal/neonatal outcomes
Population: women at risk of preterm birth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any known death after randomisation (fetal, neonatal, child, child as adult) Betamethasone acetate plus phosphate vs betamethasone phosphate – fetal/neonatal outcomes | RR 0.32 [0.01, 7.69] | 1 study · 69 participants | Very low Downgraded: risk of bias, imprecision |
Respiratory distress syndrome Betamethasone acetate plus phosphate vs betamethasone phosphate – fetal/neonatal outcomes | RR 0.19 [0.01, 3.91] | 1 study · 69 participants | Very low Downgraded: risk of bias, imprecision |
Intraventricular haemorrhage Betamethasone acetate plus phosphate vs betamethasone phosphate – fetal/neonatal outcomes | RR 0.32 [0.01, 7.69] | 1 study · 69 participants | Very low Downgraded: risk of bias, imprecision |
Necrotising enterocolitis Betamethasone acetate plus phosphate vs betamethasone phosphate – fetal/neonatal outcomes | no estimate extracted | NR | No studies |
Chronic lung disease Betamethasone acetate plus phosphate vs betamethasone phosphate – fetal/neonatal outcomes | no estimate extracted | NR | No studies |
Betamethasone 12‐hourly compared to 24‐hourly dosing – fetal/neonatal outcomes
Population: women at risk of preterm birth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any known death after randomisation (fetal, neonatal, child, child as adult) Betamethasone 12‐hourly vs 24‐hourly dosing – fetal/neonatal outcomes | RR 0.93 [0.46, 1.87] | 1 study · 255 participants | Very low Downgraded: risk of bias, imprecision |
Respiratory distress syndrome Betamethasone 12‐hourly vs 24‐hourly dosing – fetal/neonatal outcomes | RR 0.95 [0.67, 1.36] | 1 study · 253 participants | Very low Downgraded: risk of bias, imprecision |
Intraventricular haemorrhage Betamethasone 12‐hourly vs 24‐hourly dosing – fetal/neonatal outcomes | RR 1.4 [0.73, 2.7] | 1 study · 253 participants | Very low Downgraded: risk of bias, imprecision |
Chronic lung disease Betamethasone 12‐hourly vs 24‐hourly dosing – fetal/neonatal outcomes | RR 0.77 [0.48, 1.24] | 1 study · 253 participants | Very low Downgraded: risk of bias, imprecision |
Necrotising enterocolitis Betamethasone 12‐hourly vs 24‐hourly dosing – fetal/neonatal outcomes | RR 9.08 [0.54, 153.08] | 1 study · 253 participants | Very low Downgraded: risk of bias, imprecision |