Table 2.
Summary of findings (SoF)
| Early systemic hydrocortisone compared with control for preventing bronchopulmonary dysplasia in preterm infants | ||||||
|---|---|---|---|---|---|---|
|
Patient or population: chronic lung disease in preterm infants Setting: Neonatal Intensive Care Units Intervention: early systemic hydrocortisone Comparison: control | ||||||
| Outcomes | Anticipated absolute effectsa (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with control | Risk with early systemic hydrocortisone | |||||
| Survival without BPD at 36 weeks | ||||||
| All studies | 436 per 1000 | 493 per 1000 (441 to 550) | RR 1.13 (1.01 to 1.26) | 1378 (10 studies) | MODERATE | |
| BPD studies | 437 per 1000 | 520 per 1000 (454 to 590) | RR 1.19 (1.04 to 1.35) | 1019 (5 studies) | HIGH | |
| BPD at 36 weeks in survivors | ||||||
| All studies | 460 per 1000 | 418 per 1000 (372 to 474) | RR 0.91 (0.81 to 1.03) | 1198 (11 studies) | MODERATE | |
| BPD studies | 458 per 1000 | 385 per 1000 (330 to 449) | RR 0.84 (0.72 to 0.98) | 840 (5 studies) | HIGH | |
| Survival to 36 weeks | ||||||
| All studies | 818 per 1000 | 842 per 1000 (802 to 883) | RR 1.03 (0.98 to 1.08) | 1347 (9 studies) | MODERATE | |
| BPD studies | 807 per 1000 | 839 per 1000 (790 to 887) | RR 1.04 (0.98 to 1.10) | 1022 (5 studies) | HIGH | |
| Gastrointestinal perforation | ||||||
| All studies | 47 per 1000 | 79 per 1000 (50 to 126) | RR 1.69 (1.07 to 2.68) | 1099 (7 studies) | MODERATE | With concurrent treatment for PDA |
| BPD studies | 47 per 1000 | 82 per 1000 (51 to 133) | RR 1.76 (1.09 to 2.84) | 1017 (5 studies) | MODERATE | |
| Survival without moderate-severe NDI | ||||||
| All studies | 563 per 1000 | 636 per 1000 (574 to 709) | RR 1.13 (1.02 to 1.26) | 898 (4 studies) | LOW | |
| BPD studies | 565 per 1000 | 644 per 1000 (581 to 717) | RR 1.14 (1.03 to 1.27) | 856 (3 studies) | LOW | |
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: 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 certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
aThe risk in the intervention group (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