Comparison 1. Lower versus higher cumulative dose dexamethasone regimen.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death or bronchopulmonary dysplasia at 36 weeks PMA	6	209	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.82, 1.44]
1.1 Moderate versus high cumulative dose regimen	2	55	Risk Ratio (M‐H, Fixed, 95% CI)	1.35 [1.00, 1.82]
1.2 Low versus moderate cumulative dose regimen	4	154	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.50, 1.40]
2 Mortality at 36 weeks' PMA	7	265	Risk Ratio (M‐H, Fixed, 95% CI)	0.85 [0.38, 1.92]
2.1 Moderate versus high cumulative dose regimen	3	111	Risk Ratio (M‐H, Fixed, 95% CI)	1.53 [0.51, 4.55]
2.2 Low versus moderate cumulative dose regimen	4	154	Risk Ratio (M‐H, Fixed, 95% CI)	0.43 [0.11, 1.63]
3 Mortality at hospital discharge	7	265	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.52, 1.91]
3.1 Moderate versus high cumulative dose regimen	3	111	Risk Ratio (M‐H, Fixed, 95% CI)	1.48 [0.68, 3.23]
3.2 Low versus moderate cumulative dose regimen	4	154	Risk Ratio (M‐H, Fixed, 95% CI)	0.43 [0.11, 1.63]
4 Bronchopulmonary dysplasia at 36 weeks' PMA	6	209	Risk Ratio (M‐H, Fixed, 95% CI)	1.30 [0.93, 1.82]
4.1 Moderate versus high cumulative dose regimen	2	55	Risk Ratio (M‐H, Fixed, 95% CI)	1.50 [1.01, 2.22]
4.2 Low versus moderate cumulative dose regimen	4	154	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.65, 1.95]
5 Failure to extubate 3 days after initiation	4	150	Risk Ratio (M‐H, Fixed, 95% CI)	1.11 [0.93, 1.32]
5.1 Moderate versus high cumulative dose regimen	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.70, 1.39]
5.2 Low versus moderate dose regimen	3	125	Risk Ratio (M‐H, Fixed, 95% CI)	1.14 [0.93, 1.39]
6 Failure to extubate 7 days after initiation	5	207	Risk Ratio (M‐H, Fixed, 95% CI)	1.33 [1.05, 1.68]
6.1 Moderate versus high cumulative dose regimen	2	81	Risk Ratio (M‐H, Fixed, 95% CI)	1.80 [1.03, 3.14]
6.2 Low versus moderate cumulative dose regimen	3	126	Risk Ratio (M‐H, Fixed, 95% CI)	1.21 [0.94, 1.56]
7 Days of mechanical ventilation	6	217	Mean Difference (IV, Fixed, 95% CI)	4.98 [0.47, 9.49]
7.1 Moderate versus high cumulative dose regimen	3	111	Mean Difference (IV, Fixed, 95% CI)	7.41 [1.43, 13.39]
7.2 Low versus moderate cumulative dose regimen	3	106	Mean Difference (IV, Fixed, 95% CI)	1.77 [‐5.09, 8.64]
8 Days on supplemental oxygen	1	28	Mean Difference (IV, Fixed, 95% CI)	‐2.0 [‐25.29, 21.29]
8.1 Low versus moderate cumulative dose regimen	1	28	Mean Difference (IV, Fixed, 95% CI)	‐2.0 [‐25.29, 21.29]
9 Hypertension	5	181	Risk Ratio (M‐H, Fixed, 95% CI)	0.30 [0.11, 0.79]
9.1 Moderate versus high cumulative dose regimen	2	55	Risk Ratio (M‐H, Fixed, 95% CI)	0.23 [0.01, 4.36]
9.2 Low versus moderate cumulative dose regimen	3	126	Risk Ratio (M‐H, Fixed, 95% CI)	0.31 [0.11, 0.87]
10 Hyperglycemia	5	181	Risk Ratio (M‐H, Fixed, 95% CI)	0.60 [0.37, 0.97]
10.1 Moderate versus high cumulative dose regimen	2	55	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.47, 1.46]
10.2 Low versus moderate cumulative dose regimen	3	126	Risk Ratio (M‐H, Fixed, 95% CI)	0.40 [0.17, 0.93]
11 Culture confirmed infection	6	230	Risk Ratio (M‐H, Fixed, 95% CI)	0.91 [0.60, 1.38]
11.1 Moderate versus high cumulative dose regimen	2	55	Risk Ratio (M‐H, Fixed, 95% CI)	1.23 [0.62, 2.42]
11.2 Low versus moderate cumulative dose regimen	4	175	Risk Ratio (M‐H, Fixed, 95% CI)	0.78 [0.46, 1.32]
12 Clinical suspected infection	2	72	Risk Ratio (M‐H, Fixed, 95% CI)	1.03 [0.62, 1.70]
12.1 Moderate versus high cumulative dose regimen	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	1.22 [0.71, 2.09]
12.2 Low versus moderate cumulative dose regimen	1	47	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.32, 2.08]
13 Gastrointestinal hemorrhage	2	42	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.1 Moderate versus high cumulative dose regimen	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Low versus moderate cumulative dose regimen	1	17	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Gastrointestinal perforation	3	126	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.13, 6.28]
14.1 Low versus moderate cumulative dose regimen	3	126	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.13, 6.28]
15 Necrotizing enterocolitis	3	139	Risk Ratio (M‐H, Fixed, 95% CI)	0.53 [0.18, 1.56]
15.1 Moderate versus high cumulative dose regimen	1	30	Risk Ratio (M‐H, Fixed, 95% CI)	0.86 [0.23, 3.19]
15.2 Low versus moderate cumulative dose regimen	2	109	Risk Ratio (M‐H, Fixed, 95% CI)	0.23 [0.03, 1.97]
16 Intraventricular hemorrhage (> grade II)	2	42	Risk Ratio (M‐H, Fixed, 95% CI)	1.32 [0.48, 3.67]
16.1 Moderate versus high cumulative dose regimen	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.27, 4.37]
16.2 Low versus moderate cumulative dose regimen	1	17	Risk Ratio (M‐H, Fixed, 95% CI)	1.69 [0.37, 7.67]
17 Periventricular leukomalacia (PVL)	1	62	Risk Ratio (M‐H, Fixed, 95% CI)	0.88 [0.13, 5.85]
17.1 Low versus moderate cumulative dose regimen	1	62	Risk Ratio (M‐H, Fixed, 95% CI)	0.88 [0.13, 5.85]
18 Open‐label corticosteroids	6	209	Risk Ratio (M‐H, Fixed, 95% CI)	0.81 [0.57, 1.14]
18.1 Moderate versus high cumulative dose regimen	2	55	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.2 Low versus moderate cumulative dose regimen	4	154	Risk Ratio (M‐H, Fixed, 95% CI)	0.81 [0.57, 1.14]
19 Severe retinopathy of prematurity	4	117	Risk Ratio (M‐H, Fixed, 95% CI)	0.56 [0.26, 1.23]
19.1 Moderate versus high cumulative dose regimen	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	0.27 [0.04, 2.10]
19.2 Low versus moderate cumulative dose regimen	3	92	Risk Ratio (M‐H, Fixed, 95% CI)	0.66 [0.28, 1.57]
20 Cerebral palsy in survivors assessed	3	93	Risk Ratio (M‐H, Fixed, 95% CI)	2.22 [0.76, 6.49]
20.1 Moderate versus high cumulative dose regimen	1	18	Risk Ratio (M‐H, Fixed, 95% CI)	11.0 [0.70, 173.66]
20.2 Low versus moderate cumulative dose regimen	2	75	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.29, 4.00]
21 Death or cerebral palsy	3	134	Risk Ratio (M‐H, Fixed, 95% CI)	1.26 [0.65, 2.46]
21.1 Moderate versus high cumulative dose regimen	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	2.17 [0.87, 5.37]
21.2 Low versus moderate dose regimen	2	109	Risk Ratio (M‐H, Fixed, 95% CI)	0.78 [0.28, 2.18]
22 Bayley's MDI < 2 SD	3	134	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.47, 2.37]
22.1 Moderate versus high cumulative dose regimen	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	9.69 [0.58, 163.02]
22.2 Low versus moderate cumulative dose regimen	2	109	Risk Ratio (M‐H, Fixed, 95% CI)	0.61 [0.23, 1.60]
23 Severe blindness	4	151	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.05, 1.98]
23.1 Moderate versus high cumulative dose regimen	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
23.2 Low versus moderate cumulative dose regimen	3	126	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.05, 1.98]
24 Abnormal neurodevelopmental outcome in survivors assessed (various definitions)	3	89	Risk Ratio (M‐H, Fixed, 95% CI)	2.49 [0.97, 6.38]
24.1 Moderate versus high cumulative dose regimen	2	74	Risk Ratio (M‐H, Fixed, 95% CI)	8.33 [1.63, 42.48]
24.2 Low versus moderate cumulative dose regimen	1	15	Risk Ratio (M‐H, Fixed, 95% CI)	0.3 [0.05, 1.97]
25 Death or abnormal neurodevelopmental outcome (various definitions)	3	97	Risk Ratio (M‐H, Fixed, 95% CI)	1.84 [0.97, 3.50]
25.1 Moderate versus high cumulative dose regimen	2	81	Risk Ratio (M‐H, Fixed, 95% CI)	3.37 [1.42, 7.99]
25.2 Low versus moderate cumulative dose regimen	1	16	Risk Ratio (M‐H, Fixed, 95% CI)	0.43 [0.12, 1.51]