Summary of findings 1. Lower compared to higher cumulative dose dexamethasone regimen for prevention of bronchopulmonary dysplasia in preterm infants.
| Lower compared to higher cumulative dose dexamethasone regimen for prevention of bronchopulmonary dysplasia in preterm infants | ||||||
| Patient or population: preterm infants at risk for bronchopulmonary dysplasia Intervention: lower cumulative dose dexamethasone regimen Comparison: higher cumulative dose dexamethasone regimen | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with higher cumulative dose dexamethasone regimen | Risk with lower | |||||
| Death or bronchopulmonary dysplasia at 36 weeks PMA | Study population | RR 1.03 (0.86 to 1.24) | 268 (7 RCTs) | ⊕⊕⊝⊝ LOWa,b | ||
| 651 per 1000 | 671 per 1000 (560 to 808) | |||||
| Death or cerebral palsy at 1 to 3 years | Study population | RR 1.74 (0.94 to 3.24) | 193 (4 RCTs) | ⊕⊕⊝⊝ LOWa,b | ||
| 308 per 1000 | 535 per 1000 (289 to 997) | |||||
| Death or abnormal neurodevelopmental outcome (various definitions) at 1 to 3 years | Study population | RR 1.86 (0.98 to 3.53) | 100 (3 RCTs) | ⊕⊝⊝⊝ VERY LOWa,b,c | ||
| 172 per 1000 | 319 per 1000 (168 to 606) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; PMA: postmenstrual age; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
a Downgraded one level for risk of bias in some included studies b Downgraded one level for serious imprecision of effect estimates (95% CI around estimate consistent with substantial harm or benefit). c Downgraded one level for serious inconsistency across studies.