Summary of findings for the main comparison. Early inhaled steroids (< 2 weeks) compared to placebo (among all randomised) for preventing chronic lung disease in very low birth weight preterm neonates.
| Early inhaled steroids (< 2 weeks) compared to placebo (among all randomised) for preventing chronic lung disease in very low birth weight preterm neonates | ||||||
| Patient or population: very low birth weight preterm neonates Settings: neonatal intensive care units Intervention: early inhaled steroids (< 2 weeks after birth) Comparison: placebo (among all randomised) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| placebo (among all randomised) | Early inhaled steroids (< 2 weeks) | |||||
| CLD at 36 weeks' PMA oxygen dependency at 36 weeks' PMA | Study population | RR 0.97 (0.62 to 1.52) | 429 (5 studies) | ⊕⊕⊕⊝ moderate | ||
| 152 per 1000 | 148 per 1000 (94 to 231) | |||||
| Moderate | ||||||
| 115 per 1000 | 112 per 1000 (71 to 175) | |||||
| Death by, or CLD at, 36 weeks' PMA Death or oxygen dependency at 36 weeks' PMA | Study population | RR 0.86 (0.75 to 0.99) | 1285 (6 studies) | ⊕⊕⊕⊝ moderate1 | ||
| 403 per 1000 | 346 per 1000 (302 to 398) | |||||
| Moderate | ||||||
| 350 per 1000 | 301 per 1000 (262 to 347) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (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; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Method of sequence generation was unclear in all included studies except for the study by Bassler 2015. In the studies by Fok 1999, Jangaard 2002, Merz 1999 and Yong 1999 blinding of outcome assessment was unclear. Except for the study by Bassler 2015, none of the included studies were registered and we were unable to identify whether there was selective reporting or not.