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

Block 1977.

Study characteristics
Methods Type of study: RCT
Method of treatment allocation: computer‐generated randomisation sequence. Coded drug boxes were provided.
Stratification: none stated
Placebo: yes, normal saline
Sample size calculation: no
Intention‐to‐treat analyses: no
Participants Location: Department of Gynecology and Obstetrics at the University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA
Eligibility criteria: women with preterm labour and PROM
Gestational age range: not stated
Exclusion criteria: not stated
Total recruited: 167 women randomised (14 delivered elsewhere and were lost to follow‐up). Data are available on 169 infants (60 infants in the betamethasone arm, 41 infants in the methylprednisolone arm, and 54 infants in the control arm).
Interventions Group A: 12 mg betamethasone IM repeated after 24 hours if delivery had not occurred
Group B: 125 mg methylprednisolone IM repeated after 24 hours if delivery had not occurred
GRoup C: Control group received 1 mL normal saline IM repeated after 24 hours if delivery had not occurred.
If there was evidence of progressive cervical dilatation an alcohol infusion was given in order to attempt to delay delivery for at least 48 hours. In women with PROM delivery was induced if serial white blood cell counts or temperatures became elevated regardless of time elapsed since drug administration.
Outcomes Fetal/neonatal outcomes reported (fetal death, neonatal death, RDS, need for mechanical ventilation/CPAP)
Notes Further information was requested from the study authors but there was no reply.
Dates of the study: not stated in manuscript, the study is coded as 1970s for the review
Funding sources: quote: "supported in part by a grant from Schering Corporation, Kenilworth, New Jersey, USA; and The Upjohn Company, Kalamazoo, Michigan, USA"
Declarations of interest: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote:"Computer generated randomisation sequence."
Allocation concealment (selection bias) Low risk Quote:"Consecutively numbered boxes containing randomly selected study drug or placebo."
Blinding of participants and personnel (performance bias)
All outcomes Low risk Clinicians were never aware of the contents of the coded box. Placeob was saline so it is likely that participants were blinded.
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk Blinding of outcome assessors was not described.
Incomplete outcome data (attrition bias)
All outcomes Unclear risk 14 (10%) women delivered elsewhere and were lost to follow‐up. 6 (4%) women were excluded from analyses as they failed to complete the protocol (1 in the betamethasone group, 2 in the methylprednisolone group, and 3 in the control group).
Selective reporting (reporting bias) Low risk Study protocol not available, but appears to report on all pre‐specified outcomes.
Other bias Low risk Nothing to indicate any other sources of bias.