8. Cerebral palsy or death.
Intervention and comparison | Outcome | Assumed risk with comparator | Corresponding risk with intervention | Relative effect (95% CI) | Number of participants (trials) | Quality of the evidence (GRADE) | Comments |
Neonatal care: bronchopulmonary dysplasia | |||||||
Early (< 8 days) postnatal corticosteroids vs placebo or no treatment for preventing chronic lung disease in preterm infants (Doyle 2014b) | Cerebral palsy or death at 11 months to 7 to 9 years | 352 per 1000 (252/715) |
384 per 1000 (334 to 441) | RR 1.09 (0.95 to 1.25) | 1452 (12 RCTs) | MODERATE | Study limitations (‐1): 4 RCTs at unclear risk of selection bias; 2 RCTs at high risk of performance and detection bias; 2 RCTs had 13% to 53% follow‐up overall |
Moderately early (7‐14 days) postnatal corticosteroids vs placebo or no treatment for preventing chronic lung disease in preterm infants (Halliday 2003) | Cerebral palsy or death at 12 months' corrected age up to 90 months | 316 per 1000 (30/95) |
262 per 1000 (174 to 388) | RR 0.83 (0.55 to 1.23) | 204 (4 RCTs) | VERY LOW | Study limitations (‐1): 2 RCTs with 68% to 70% follow‐up; 1 RCT with unclear blinding of outcome assessment Imprecision (‐2): wide CI crossing line of no effect; small sample sizes |
Late (> 7 days) postnatal corticosteroids vs placebo or no treatment for chronic lung disease in preterm infants (Doyle 2014) | Cerebral palsy or death at 1 to 3 years | 328 per 1000 (142/433) |
302 per 1000 (249 to 367) | RR 0.92 (0.76 to 1.12) | 876 (14 RCTs) | LOW | Study limitations (‐1): 5 RCTs unclear risk of selection bias; 5 RCTs with follow‐up between 32% and 78% Imprecision (‐1): wide CI crossing line of no effect |
Cerebral palsy or death at latest reported age (from 1 year up to 17 years) | 312 per 1000 (132/423) |
296 per 1000 (240 to 362) | RR 0.95 (0.77 to 1.16) | 855 (15 RCTs) | LOW | Study limitations (‐1): 5 RCTs unclear risk of selection bias; 7 RCTs with follow‐up between 32% and 78% Imprecision (‐1): wide CI crossing line of no effect |
|
Neonatal care: other | |||||||
Thyroid hormones vs placebo for preventing neurodevelopmental impairment in preterm infants (Osborn 2001) | Cerebral palsy or death at 5.7 years | 300 per 1000 (30/100) |
210 per 1000 (129 to 342) | RR 0.70 (0.43 to 1.14) | 200 (1 RCT) | LOW | Imprecision (‐2): wide CI crossing line of no effect; 1 small RCT |
Prophylactic thyroid hormones vs placebo for prevention of morbidity and mortality in preterm infants (Osborn 2007) |
Abbreviations: CI: confidence interval; GRADE: Grades of Recommendation, Assessment, Development and Evaluation; RCT: randomised controlled trial; RR: risk ratio.