Cochrane · systematic review · CD010941
Systemic corticosteroid regimens for prevention of bronchopulmonary dysplasia in preterm infants
Onland, W, van de Loo, M, Offringa, M, et al. · Cochrane Database of Systematic Reviews · 2023 · 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
11
current version
GRADE rated
11
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 18.2%Low 8 · 72.7%Moderate 1 · 9.1%High 0 · 0%
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 onlyLower compared to higher cumulative dose dexamethasone regimen for prevention of bronchopulmonary dysplasia in preterm infants
Population: preterm infants at risk for bronchopulmonary dysplasia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia at 36 weeks PMA Lower vs higher cumulative dose dexamethasone regimen | RR 1.03 [0.86, 1.24] | 7 studies · 268 participants | Low Downgraded: risk of bias, imprecision |
Death or cerebral palsy at 1 to 3 years Lower vs higher cumulative dose dexamethasone regimen | RR 1.74 [0.94, 3.24] | 4 studies · 193 participants | Low Downgraded: risk of bias, imprecision |
Death or abnormal neurodevelopmental outcome (various definitions) at 1 to 3 years Lower vs higher cumulative dose dexamethasone regimen | RR 1.86 [0.98, 3.53] | 3 studies · 100 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Later compared to earlier initiation of dexamethasone therapy for prevention of bronchopulmonary dysplasia in preterm infants
Population: preterm infants at risk for bronchopulmonary dysplasia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia at 36 weeks' PMA Later vs earlier initiation of dexamethasone therapy | RR 1.06 [0.87, 1.29] | 3 studies · 391 participants | Low Downgraded: risk of bias, imprecision |
Death or cerebral palsy at 1 to 3 years Later vs earlier initiation of dexamethasone therapy | RR 1.12 [0.68, 1.84] | 1 study · 86 participants | Low Downgraded: risk of bias, imprecision |
Death or abnormal neurodevelopmental outcome (various definitions) Later vs earlier initiation of dexamethasone therapy | RR 0.87 [0.63, 1.21] | 2 studies · 167 participants | Low Downgraded: risk of bias, imprecision |
Pulse compared to continuous dexamethasone therapy for prevention of bronchopulmonary dysplasia in preterm infants
Population: preterm infants at risk for bronchopulmonary dysplasia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia at 36 weeks' PMA Pulse vs continuous dexamethasone therapy | RR 1.38 [1.02, 1.88] | 2 studies · 197 participants | Low Downgraded: risk of bias, imprecision |
Death or abnormal neurodevelopmental outcome (various definitions) Pulse vs continuous dexamethasone therapy | RR 1.23 [0.79, 1.92] | 1 study · 76 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Individual tailored compared to continuous tapered dexamethasone regimen for prevention of bronchopulmonary dysplasia in preterm infants
Population: preterm infants at risk for bronchopulmonary dysplasia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia at 36 weeks PMA Individual tailored vs continuous tapered dexamethasone regimen | RR 1.06 [0.88, 1.29] | 3 studies · 168 participants | Low Downgraded: risk of bias, imprecision |
Death or cerebral palsy at 1 to 3 years Individual tailored vs continuous tapered dexamethasone regimen | RR 7.24 [0.95, 55.26] | 1 study · 59 participants | Moderate Downgraded: imprecision |
Death or abnormal neurodevelopmental outcome (various definitions) Individual tailored vs continuous tapered dexamethasone regimen | RR 1.44 [0.99, 2.07] | 3 studies · 168 participants | Low Downgraded: risk of bias, imprecision |
Higher versus lower cumulative dosage regimens of dexamethasone to prevent BPD in preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia at 36 weeks' PMA ‐ Moderate versus high cumulative dose regimen Higher vs lower cumulative dosage regimens of dexamethasone | RR 1.35 [1, 1.82] | 2 studies · 55 participants | Very low Downgraded: risk of bias |
Death or bronchopulmonary dysplasia at 36 weeks' PMA ‐ Low versus moderate cumulative dose regimen Higher vs lower cumulative dosage regimens of dexamethasone | RR 0.83 [0.5, 1.4] | 4 studies · 154 participants | Very low Downgraded: risk of bias |
Death or cerebral palsy ‐ Moderate versus high cumulative dose regimen Higher vs lower cumulative dosage regimens of dexamethasone | RR 2.17 [0.87, 5.37] | 1 study · 25 participants | Low Downgraded: risk of bias |
Death or cerebral palsy ‐ Low versus moderate dose regimen Higher vs lower cumulative dosage regimens of dexamethasone | RR 0.78 [0.28, 2.18] | 2 studies · 109 participants | Very low Downgraded: risk of bias |
Death or abnormal neurodevelopmental outcome (various definitions) ‐ Moderate versus high cumulative dose regimen Higher vs lower cumulative dosage regimens of dexamethasone | RR 3.37 [1.42, 7.99] | 2 studies · 81 participants | Low Downgraded: risk of bias |
Death or abnormal neurodevelopmental outcome (various definitions) ‐ Low versus moderate cumulative dose regimen Higher vs lower cumulative dosage regimens of dexamethasone | RR 0.43 [0.12, 1.51] | 1 study · 16 participants | Low Downgraded: risk of bias |
Earlier versus later initiation of dexamethasone therapy to prevent BPD in preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia at 36 weeks PMA ‐ Moderate early versus early initiation Earlier vs later initiation of dexamethasone therapy | RR 1.06 [0.87, 1.29] | 3 studies · 391 participants | Very low Downgraded: risk of bias |
Death or cerebral palsy ‐ Moderate early versus early initiation Earlier vs later initiation of dexamethasone therapy | RR 1.12 [0.68, 1.84] | 1 study · 86 participants | Very low Downgraded: risk of bias |
Death or abnormal neurodevelopmental outcome (various definitions) ‐ Moderate early versus early Earlier vs later initiation of dexamethasone therapy | RR 0.87 [0.63, 1.21] | 2 studies · 167 participants | Very low Downgraded: risk of bias |
Pulse versus tapered continuous dosage regimens to prevent BPD in preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia at 36 weeks PMA Pulse vs tapered continuous dosage regimens | RR 1.38 [1.02, 1.88] | 2 studies · 197 participants | Low Downgraded: risk of bias |
Death or abnormal neurodevelopmental outcome (various definitions) Pulse vs tapered continuous dosage regimens | RR 1.23 [0.79, 1.92] | 1 study · 76 participants | Very low Downgraded: risk of bias |
Individually tailored versus tapered continuous dosage regimens to prevent BPD in preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Death or bronchopulmonary dysplasia at 36 weeks PMA Individually tailored vs tapered continuous dosage regimens | RR 1.17 [0.83, 1.66] | 2 studies · 109 participants | Low Downgraded: risk of bias |
Death or abnormal neurodevelopmental outcome (various definitions) Individually tailored vs tapered continuous dosage regimens | RR 1.06 [0.55, 2.06] | 2 studies · 109 participants | Low Downgraded: risk of bias |