Bloomfield 1998.

Methods	Randomized controlled trial comparing a pulse course against high‐dosage regimen dexamethasone.
Participants	Infants with a birth weight ≤ 1250 grams, and ventilated at ≥ 15 cycles/min at 7 days of age. Infants with major congenital malformations or who were ventilated for surgical reasons were excluded.
Interventions	The infants were randomly assigned to 1 of 2 regimens. Pulse arm: infants received dexamethasone 0.5 mg/kg/day for 3 consecutive days. The pulse course was repeatable every 10 days if still ventilated or supplemental oxygen and < 36 weeks' PMA. Continuous arm: starting at 14 days of age if still ventilated at ≥ 15 cycles/min and ≥ 30% supplemental oxygen, a high‐dosage regimen with a cumulative dose of 7.9 mg/kg of dexamethasone administered over a 42‐day course: 0.5 mg/kg/day for 3 days, 0.3 mg/kg/day for 3 days, a 10% decrease every 3 days until 0.1 mg/kg/day, 0.1 mg/kg/day for 3 days, 0.1 mg/kg/day on alternate days for 7 days. The initial dosage administration of 0.5 mg/kg/day was in 2 divided doses.
Outcomes	The primary outcome was linear growth, measured as weight gain, crown‐heel length, and head circumference. Secondary outcomes were hypertension, hyperglycemia requiring insulin therapy, necrotizing enterocolitis, retinopathy of prematurity, proven infections, myocardial hypertrophy, supplemental oxygen at 28 days' PNA and 36 weeks' PMA, BPD at 28 days' PNA and 36 weeks' PMA. In addition a Synacthen test was performed 1 week after discontinuation of the dexamethasone. The long‐term follow‐up manuscript reported on neurodevelopmental outcome with an extended inclusion rate. Infants were classified into 1 of 4 outcome categories defined and modified from Kitchen 1987.
Notes	Original authors provided additional data.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	By computer randomization.
Allocation concealment (selection bias)	Low risk	By computer randomization, no additional details. Randomizaton was balanced in blocks of 6 and stratified by sex and birth weight.
Blinding of participants and personnel (performance bias) All outcomes	High risk	No blinding of the intervention.
Blinding of outcome assessment (detection bias) All outcomes	High risk	No blinding of outcome assessment.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Intention‐to‐treat analysis. 1 infant was found to have a birth weight of > 1250 grams. 3 infants were lost to follow‐up.
Selective reporting (reporting bias)	Low risk	All predefined outcomes were mentioned in the manuscript.
Other bias	Low risk	No concerns of other biases.