Summary of findings 2. Maternal outcomes: corticosteroids compared to placebo or no treatment for accelerating fetal lung maturation for women at risk of preterm birth.
| Maternal outcomes: corticosteroids compared to placebo or no treatment for accelerating fetal lung maturation for women at risk of preterm birth | ||||||
| Patient or population: women at risk of preterm birth Setting: hospitals settings in low‐, middle‐ and high‐resource countries Intervention: corticosteroids Comparison: placebo or no treatment | ||||||
| Outcomes | Relative effect (95% CI) | Anticipated absolute effects* (95% CI) | Certainty of the evidence (GRADE) | What happens | ||
| Without Corticosteroids | With Corticosteroids | Difference | ||||
| Maternal death follow up: 90 days № of participants: 6244 (6 RCTs) | RR 1.19 (0.36 to 3.89) | Study population | ⊕⊕⊕⊝ MODERATE 1 | Corticosteroids probably result in little to no difference in maternal death, but the wide 95% CI includes possible benefit and possible harm, compared to placebo or no treatment. Four studies (3174 women) reported zero deaths in either arm. |
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| 0.2% | 0.2% (0.1 to 0.6) | 0.0% fewer (0.1 fewer to 0.5 more) | ||||
| Chorioamnionitis № of participants: 8374 (15 RCTs) | RR 0.86 (0.69 to 1.08) | Study population | ⊕⊕⊕⊝ MODERATE 2 | Corticosteroids probably make little to no difference to the risk of chorioamnionitis but the wide 95% CI includes possible benefit and possible harm, compared to placebo/no treatment. | ||
| 3.5% | 3.0% (2.4 to 3.8) | 0.5% fewer (1.1 fewer to 0.3 more) | ||||
| Endometritis № of participants: 6764 (10 RCTs) | RR 1.14 (0.82 to 1.58) | Study population | ⊕⊕⊕⊝ MODERATE 1 | Corticosteroids probably make little to no difference to the risk of endometritis but the wide 95% CI includes possible benefit and possible harm, compared to placebo/no treatment. | ||
| 1.8% | 2.1% (1.5 to 2.9) | 0.3% more (0.3 fewer to 1.1 more) | ||||
| *The 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, | ||||||
| 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. | ||||||
1 Downgraded one level for imprecision: few events and wide 95% CI that includes possible benefit and possible harm
2 Downgraded one level for imprecision: wide 95% CI that includes possible benefit and possible harm