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. 2023 Aug 2;382:e076035. doi: 10.1136/bmj-2023-076035

Table 2.

Characteristics of included randomised controlled trials in a systematic review and meta-analysis on term, late preterm, and term/late preterm births after early exposure to antenatal corticosteroids

Studies by gestation and outcomes (country) Inclusion criteria ACS treatment (type of ACS) Risk of bias assessment (Cochrane RoB*) in order R, D, Mi, Me, S, O
Proportion of infants
Born at term:
 Schmitz 2022 (France)54 •       Singleton pregnancy at risk of preterm birth between 2017 and 2019
•       Gestational age <32 weeks at trial entry
•       Received 1 dose of ACS before trial entry
•       Age ≥18 years
1 course betamethasone v placebo +, + ,+, +, + , +
 WHO ACTION-1 Trial Collaborators 2020 (international)55 •       Singleton or multiple pregnancy between 2017 and 2019
•       Gestational age 26-33+6 weeks at trial entry
•       No previous ACS exposure but planned or expected birth ≤48 hours
1 course dexamethasone with one potential repeat course if birth did not occur after 7 days v placebo +, +, +, +, +, +
 Crowther 2006 (Australia and New Zealand)56 •       Single, twin, or triplet pregnancy between 1998 and 2004
•       Gestational age <32 weeks at trial entry
•       Received 1 complete course of ACS ≥7 days previously and remained at risk of preterm birth
•       No contraindication to further corticosteroids
Repeat dose betamethasone v placebo + ,+ ,+, + ,+ , +
 Danesh 2012 (Iran)57 •       Singleton pregnancy at risk of preterm birth in 2011
•       Gestational age 24-34 weeks at trial entry
•       16-45 years of age at high risk of preterm labour with intact membranes or PPROM
•       Residence in Isfahan, low Bishop Score (≤5), non-smoker, and hospital admission ≥3 days
1 course betamethasone v 1 course dexamethasone +, + ,+, + ,?, ?
Born late preterm:
 Schmitz 2022 (France)54 •       Singleton pregnancy at risk of preterm birth between 2017 and 2019
•       Gestational age <32 weeks at trial entry
•       Received 1 dose of ACS before trial entry
•       Age ≥18 years
1 course betamethasone v placebo + ,+ ,+, +, +, +
 Crowther 2006 (Australia and New Zealand)56 •       Single, twin, or triplet pregnancy between 1998 and 2004
•       Gestational age <32 weeks at trial entry
•       Received 1 complete course of ACS ≥7 days previously and remained at risk of preterm birth
•       No contraindication to further corticosteroids
Repeat dose betamethasone v placebo + ,+ ,+, + ,+, +
 Peltoniemi 2007 (Finland)58 •       Singleton or multiple pregnancy between 2001 and 2005
•       Gestational age <34 weeks at trial entry
•       Received 1 complete course ≥7 days before trial entry and preterm birth was imminent
•       High risk of spontaneous delivery <48 hours indicated by cervical opening ≥3 cm, regular contractions, or PPROM
1 repeat dose betamethasone v placebo +,+, +, +, ?, ?
Born at term/late preterm (combined):
 Schmitz 2022 (France)54 •       Singleton pregnancy at risk of preterm birth between 2017 and 2019
•       Gestational age <32 weeks at trial entry
•       Received 1 dose of ACS before trial entry
•       Age ≥18 years
1 course betamethasone v placebo +, +, +, +, +, +
 McEvoy 2010 (USA)59 •       Singleton or twin pregnancy between 2001 and 2007
•       Gestational age <34 weeks at trial entry
•       Received 1 complete course of ACS ≥14 days previously and remained at risk of preterm birth
1 repeat course betamethasone v placebo +, +, +, +, +, +
 Garite 2009 (USA)60 •       Singleton or twin pregnancy between 2003 and 2008
•       Gestational age 25-32+6 weeks at trial entry
•       Received 1 complete course of ACS ≥14 days before enrolment and <30 weeks
•       Recurrent or continued risk of preterm birth within next 7 days
1 repeat course betamethasone or dexamethasone v placebo +, +, +, +, +, +
 Crowther 2006 (Australia and New Zealand)56 •       Single, twin, or triplet pregnancy between 1998 and 2004
•       Gestational age <32 weeks at trial entry
•       Received 1 complete course of ACS ≥7 days ago and remained at risk of preterm birth
•       No contraindication to further corticosteroids
Repeat dose betamethasone v placebo +, +, +, +, +, +

ACS=antenatal corticosteroids; PPROM=preterm premature rupture of membranes; RoB=risk of bias; WHO=World Health Organization.

*

Cochrane RoB 2 used for randomised controlled trials: +=low risk of bias; −=high risk of bias; ?=some concerns about bias; D=bias due to deviations from intended interventions; Me=bias in measurement of outcome; Mi=bias due to missing outcome data; O=overall risk in bias; R=bias arising from randomisation process; S=bias in selection of reported results.