Summary of findings for the main comparison. Systemic corticosteroids (dexamethasone or hydrocortisone) compared with control (placebo or nothing) for chronic lung disease in preterm infants.
| Systemic corticosteroids (dexamethasone or hydrocortisone) compared with control (placebo or nothing) for chronic lung disease in preterm infants | ||||||
| Patient or population: preterm infants with chronic lung disease Setting: neonatal intensive care units Intervention: systemic corticosteroids (dexamethasone or hydrocortisone) Comparison: control (placebo or nothing) | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with control (placebo or nothing) | Risk with systemic corticosteroids (dexamethasone or hydrocortisone) | |||||
| Mortality at 36 weeks | Study population | RR 0.82 (0.50 to 1.35) | 360 (7 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| 162 per 1000 | 133 per 1000 (81 to 219) | |||||
| Mortality at latest reported age | Study population | RR 0.84 (0.66 to 1.07) | 1035 (19 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| 206 per 1000 | 173 per 1000 (136 to 221) | |||||
| BPD at 36 weeks | Study population | RR 0.77 (0.67 to 0.88) | 580 (11 RCTs) | ⊕⊕⊕⊝ MODERATEa | ||
| 642 per 1000 | 494 per 1000 (430 to 565) | |||||
| Home on oxygen | Study population | RR 0.71 (0.54 to 0.94) | 611 (7 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| 273 per 1000 | 194 per 1000 (147 to 256) | |||||
| Death or BPD at 36 weeks | Study population | RR 0.77 (0.70 to 0.86) | 580 (11 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| 779 per 1000 | 600 per 1000 (545 to 670) | |||||
| Cerebral palsy ‐ at latest reported age | Study population | RR 1.16 (0.82 to 1.64) | 919 (16 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| 114 per 1000 | 132 per 1000 (94 to 187) | |||||
| Death or cerebral palsy ‐ at latest reported age | Study population | RR 0.95 (0.78 to 1.15) | 919 (16 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| 318 per 1000 | 302 per 1000 (248 to 366) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence. High quality: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: 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 quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded one level because publication bias was suspected.