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. 2020 Dec 25;2020(12):CD004454. doi: 10.1002/14651858.CD004454.pub4

Comparison 1. Corticosteroids versus placebo or no treatment.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Perinatal death 14 9833 Risk Ratio (M‐H, Fixed, 95% CI) 0.85 [0.77, 0.93]
1.2 Neonatal death 22 10609 Risk Ratio (M‐H, Fixed, 95% CI) 0.78 [0.70, 0.87]
1.3 Fetal death 14 9833 Risk Ratio (M‐H, Fixed, 95% CI) 1.01 [0.83, 1.22]
1.4 Respiratory distress syndrome 26 11183 Risk Ratio (M‐H, Fixed, 95% CI) 0.71 [0.65, 0.78]
1.5 Moderate/severe respiratory distress syndrome 7 4874 Risk Ratio (M‐H, Fixed, 95% CI) 0.70 [0.59, 0.83]
1.6 Chronic lung disease 5 745 Risk Ratio (M‐H, Random, 95% CI) 0.86 [0.41, 1.79]
1.7 Intraventricular haemorrhage 12 8475 Risk Ratio (M‐H, Fixed, 95% CI) 0.58 [0.45, 0.75]
1.7.1 Any IVH grade 5 720 Risk Ratio (M‐H, Fixed, 95% CI) 0.62 [0.45, 0.84]
1.7.2 IVH Grade 3‐4 5 6269 Risk Ratio (M‐H, Fixed, 95% CI) 0.49 [0.27, 0.88]
1.7.3 IVH diagnosed at postmortem 2 1486 Risk Ratio (M‐H, Fixed, 95% CI) 0.60 [0.34, 1.06]
1.8 Mean birthweight (g) 19 9551 Mean Difference (IV, Fixed, 95% CI) ‐14.02 [‐33.79, 5.76]
1.9 Maternal death 6 6244 Risk Ratio (M‐H, Fixed, 95% CI) 1.19 [0.36, 3.89]
1.10 Chorioamnionitis 15 8374 Risk Ratio (M‐H, Fixed, 95% CI) 0.86 [0.69, 1.08]
1.11 Endometritis 10 6764 Risk Ratio (M‐H, Fixed, 95% CI) 1.14 [0.82, 1.58]
1.12 Death in childhood 4 1010 Risk Ratio (M‐H, Fixed, 95% CI) 0.68 [0.36, 1.27]
1.13 Neurodevelopmental disability in childhood 5   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.13.1 Developmental delay 3 600 Risk Ratio (M‐H, Fixed, 95% CI) 0.51 [0.27, 0.97]
1.13.2 Intellectual impairment 3 778 Risk Ratio (M‐H, Fixed, 95% CI) 0.86 [0.44, 1.69]
1.13.3 Hearing impairment 2 166 Risk Ratio (M‐H, Fixed, 95% CI) 0.64 [0.04, 9.87]
1.13.4 Visual impairment 2 166 Risk Ratio (M‐H, Fixed, 95% CI) 0.55 [0.24, 1.23]
1.14 Death into adulthood 1 988 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.56, 1.81]
1.15 Neurodevelopmental disability in adulthood 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.15.1 Visual impairment 1 192 Risk Ratio (M‐H, Fixed, 95% CI) 0.91 [0.53, 1.55]
1.15.2 Hearing impairment 1 192 Risk Ratio (M‐H, Fixed, 95% CI) 0.24 [0.03, 2.03]
1.15.3 Intellectual impairment 2 273 Risk Ratio (M‐H, Fixed, 95% CI) 0.24 [0.01, 4.95]
1.16 Fever in women after trial entry requiring the use of antibiotics 3 363 Risk Ratio (M‐H, Fixed, 95% CI) 0.66 [0.36, 1.21]
1.17 Intrapartum fever in woman requiring the use of antibiotics 2 319 Risk Ratio (M‐H, Fixed, 95% CI) 0.60 [0.15, 2.49]
1.18 Postnatal fever in woman 5 1323 Risk Ratio (M‐H, Fixed, 95% CI) 0.92 [0.64, 1.33]
1.19 Admission into adult intensive care unit 2 319 Risk Ratio (M‐H, Fixed, 95% CI) 0.74 [0.26, 2.05]
1.20 Side effects of therapy in women 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.20.1 Any side effects at first dose 1 2825 Risk Ratio (M‐H, Fixed, 95% CI) 0.69 [0.59, 0.82]
1.20.2 Dyspnoea 1 2828 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.15]
1.20.3 Gastrointestinal upset 1 2828 Risk Ratio (M‐H, Fixed, 95% CI) 2.99 [0.12, 73.37]
1.20.4 Hyperglycaemia 1 2828 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.15]
1.20.5 Leucocytosis 1 2828 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.15]
1.20.6 Migraine 1 2828 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.06, 15.93]
1.21 Glucose intolerance 1 123 Risk Ratio (M‐H, Fixed, 95% CI) 2.71 [1.14, 6.46]
1.22 Hypertension 2 288 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.59, 1.79]
1.23 Apgar < 7 at 5 minutes 12 5727 Risk Ratio (M‐H, Fixed, 95% CI) 0.88 [0.78, 0.98]
1.24 Mean interval between trial entry and birth (days) 3 1513 Mean Difference (IV, Fixed, 95% CI) 0.23 [‐1.86, 2.32]
1.25 Mean length at birth (cm) 1 2766 Mean Difference (IV, Fixed, 95% CI) 0.00 [‐0.37, 0.37]
1.26 Mean head circumference at birth (cm) 1 2766 Mean Difference (IV, Fixed, 95% CI) 0.00 [‐0.22, 0.22]
1.27 Small‐for‐gestational age 5 3478 Risk Ratio (M‐H, Fixed, 95% CI) 1.11 [0.96, 1.28]
1.28 Admission to neonatal intensive care unit 9 6667 Risk Ratio (M‐H, Fixed, 95% CI) 0.96 [0.91, 1.00]
1.29 Need for mechanical ventilation/CPAP 11 4519 Risk Ratio (M‐H, Fixed, 95% CI) 0.75 [0.66, 0.84]
1.30 Mean duration of mechanical ventilation/CPAP (days) 3 471 Mean Difference (IV, Random, 95% CI) ‐1.91 [‐4.59, 0.76]
1.31 Median (IQR) duration of mechanical ventilation (hours) 1   Other data No numeric data
1.32 Median (IQR) duration of CPAP (hours) 1   Other data No numeric data
1.33 Air leak syndrome 2 2965 Risk Ratio (M‐H, Fixed, 95% CI) 0.76 [0.32, 1.80]
1.34 Mean duration of oxygen supplementation (hours) 1 73 Mean Difference (IV, Fixed, 95% CI) ‐2.86 [‐5.51, ‐0.21]
1.35 Median (IQR) duration of oxygen supplementation (hours) 1   Other data No numeric data
1.36 Surfactant use 6 6104 Risk Ratio (M‐H, Fixed, 95% CI) 0.65 [0.50, 0.85]
1.37 Systemic infection in the first 48 hours of life 7 1708 Risk Ratio (M‐H, Fixed, 95% CI) 0.60 [0.41, 0.88]
1.38 Proven infection while in the neonatal intensive care unit 10 5521 Risk Ratio (M‐H, Fixed, 95% CI) 0.79 [0.64, 0.98]
1.39 Necrotising enterocolitis 10 4702 Risk Ratio (M‐H, Fixed, 95% CI) 0.50 [0.32, 0.78]
1.40 Mean infant HPA axis function (cortisol) 1 27 Mean Difference (IV, Fixed, 95% CI) 3.94 [‐3.12, 11.00]
1.40.1 In babies born < 24 hours after 1st dose 1 6 Mean Difference (IV, Fixed, 95% CI) 9.00 [‐11.93, 29.93]
1.40.2 In babies born 24‐48 hours after 1st dose 1 10 Mean Difference (IV, Fixed, 95% CI) 0.00 [‐8.68, 8.68]
1.40.3 In babies born > 48 hours after 1st dose 1 11 Mean Difference (IV, Fixed, 95% CI) 13.00 [‐1.90, 27.90]
1.41 Mean childhood weight (kg) 2 333 Mean Difference (IV, Fixed, 95% CI) 0.30 [‐0.39, 1.00]
1.41.1 Liggins 1 250 Mean Difference (IV, Fixed, 95% CI) 0.40 [‐0.32, 1.12]
1.41.2 Schutte (females) 1 39 Mean Difference (IV, Fixed, 95% CI) ‐2.40 [‐6.55, 1.75]
1.41.3 Schutte (males) 1 44 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐3.88, 3.68]
1.42 Mean childhood head circumference (cm) 2 328 Mean Difference (IV, Fixed, 95% CI) 0.27 [‐0.08, 0.63]
1.42.1 Liggins 1 250 Mean Difference (IV, Fixed, 95% CI) 0.30 [‐0.11, 0.71]
1.42.2 Schutte (females) 1 36 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐1.05, 0.85]
1.42.3 Schutte (males) 1 42 Mean Difference (IV, Fixed, 95% CI) 0.60 [‐0.51, 1.71]
1.43 Mean childhood height (cm) 2 334 Mean Difference (IV, Fixed, 95% CI) 1.02 [‐0.26, 2.29]
1.43.1 Liggins 1 250 Mean Difference (IV, Fixed, 95% CI) 1.00 [‐0.39, 2.39]
1.43.2 Schutte (females) 1 39 Mean Difference (IV, Fixed, 95% CI) 1.70 [‐3.08, 6.48]
1.43.3 Schutte (males) 1 45 Mean Difference (IV, Fixed, 95% CI) 0.60 [‐3.79, 4.99]
1.44 Mean childhood systolic blood pressure (mmHg) 1 223 Mean Difference (IV, Fixed, 95% CI) ‐1.60 [‐4.06, 0.86]
1.45 Cerebral palsy in childhood 5 904 Risk Ratio (M‐H, Fixed, 95% CI) 0.60 [0.34, 1.03]
1.46 Behavioural/learning difficulties in childhood 1 90 Risk Ratio (M‐H, Fixed, 95% CI) 0.86 [0.35, 2.09]
1.47 Mean adult weight (kg) 2 538 Mean Difference (IV, Random, 95% CI) ‐0.83 [‐6.41, 4.76]
1.47.1 Schutte (females) 1 37 Mean Difference (IV, Random, 95% CI) ‐6.00 [‐12.93, 0.93]
1.47.2 Schutte (males) 1 43 Mean Difference (IV, Random, 95% CI) ‐1.00 [‐9.91, 7.91]
1.47.3 Liggins 1 458 Mean Difference (IV, Random, 95% CI) 2.57 [‐0.72, 5.86]
1.48 Mean adult head circumference (cm) 2 537 Mean Difference (IV, Fixed, 95% CI) 0.03 [‐0.33, 0.38]
1.48.1 Schutte (females) 1 37 Mean Difference (IV, Fixed, 95% CI) 0.00 [‐1.03, 1.03]
1.48.2 Schutte (males) 1 42 Mean Difference (IV, Fixed, 95% CI) ‐0.20 [‐1.37, 0.97]
1.48.3 Liggins 1 458 Mean Difference (IV, Fixed, 95% CI) 0.06 [‐0.34, 0.46]
1.49 Mean adult height (cm) 2 537 Mean Difference (IV, Fixed, 95% CI) 0.91 [‐0.28, 2.10]
1.49.1 Schutte (females) 1 36 Mean Difference (IV, Fixed, 95% CI) ‐1.00 [‐5.37, 3.37]
1.49.2 Schutte (males) 1 43 Mean Difference (IV, Fixed, 95% CI) 3.00 [‐2.30, 8.30]
1.49.3 Liggins (females) 1 234 Mean Difference (IV, Fixed, 95% CI) 1.17 [‐0.65, 2.99]
1.49.4 Liggins (males) 1 224 Mean Difference (IV, Fixed, 95% CI) 0.75 [‐1.03, 2.53]
1.50 Mean adult skinfold thickness (log values) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.50.1 Triceps 1 456 Mean Difference (IV, Fixed, 95% CI) ‐0.02 [‐0.11, 0.07]
1.50.2 Biceps 1 456 Mean Difference (IV, Fixed, 95% CI) ‐0.01 [‐0.11, 0.09]
1.50.3 Subscapular 1 441 Mean Difference (IV, Fixed, 95% CI) 0.01 [‐0.08, 0.10]
1.50.4 Suprailiac 1 452 Mean Difference (IV, Fixed, 95% CI) ‐0.01 [‐0.12, 0.10]
1.51 Abnormal lung function measured as forced vital capacity (adult) 1 383 Mean Difference (IV, Fixed, 95% CI) ‐0.70 [‐3.16, 1.76]
1.52 Mean adult systolic blood pressure (mmHg) 2 545 Mean Difference (IV, Fixed, 95% CI) ‐0.87 [‐2.81, 1.07]
1.52.1 Schutte (females) 1 38 Mean Difference (IV, Fixed, 95% CI) ‐4.00 [‐9.12, 1.12]
1.52.2 Schutte (males) 1 52 Mean Difference (IV, Fixed, 95% CI) ‐3.00 [‐7.17, 1.17]
1.52.3 Liggins 1 455 Mean Difference (IV, Fixed, 95% CI) 0.55 [‐1.88, 2.98]
1.53 Mean adult insulin (log values) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.53.1 Fasting 1 435 Mean Difference (IV, Fixed, 95% CI) 0.08 [‐0.03, 0.19]
1.53.2 30 minutes fasting following a 75 g oral glucose tolerance test 1 412 Mean Difference (IV, Fixed, 95% CI) 0.16 [0.04, 0.28]
1.53.3 120 minutes following a 75 g oral glucose tolerance test 1 428 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐0.27, 0.07]
1.54 Mean adult glucose 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.54.1 Fasting 1 432 Mean Difference (IV, Fixed, 95% CI) 0.01 [‐0.09, 0.11]
1.54.2 30 minutes fasting following a 75 g oral glucose tolerance test 1 413 Mean Difference (IV, Fixed, 95% CI) 0.21 [‐0.12, 0.54]
1.54.3 120 minutes following a 75 g oral glucose tolerance test 1 410 Mean Difference (IV, Fixed, 95% CI) ‐0.27 [‐0.52, ‐0.02]
1.55 Mean adult HPA axis function (mean log fasting cortisol) 1 444 Mean Difference (IV, Fixed, 95% CI) 0.06 [‐0.02, 0.14]
1.56 Mean age at puberty (years) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.56.1 Schutte (females) 1 38 Mean Difference (IV, Fixed, 95% CI) 0.00 [‐0.94, 0.94]
1.57 Educational achievement by adulthood (university or polytechnic education) 1 534 Risk Ratio (M‐H, Fixed, 95% CI) 0.94 [0.80, 1.10]
1.58 Mean length of antenatal hospitalisation (days) 2 412 Mean Difference (IV, Fixed, 95% CI) ‐0.00 [‐0.23, 0.22]
1.59 Length of maternal hospital stay 4   Other data No numeric data
1.60 Mean length of postnatal hospitalisation (days) 1 218 Mean Difference (IV, Fixed, 95% CI) 0.00 [‐1.72, 1.72]
1.61 Mean length of neonatal hospitalisation (days) 5 788 Mean Difference (IV, Fixed, 95% CI) 0.18 [‐0.51, 0.87]
1.62 Length of neonatal hospitalisation 2   Other data No numeric data