Corticosteroids for the prevention of bronchopulmonary dysplasia in preterm infants: a network meta-analysis

Archives of Disease in Childhood. Fetal and Neonatal Edition
Linan ZengLingli Zhang

Abstract

To determine the comparative efficacy and safety of corticosteroids in the prevention of bronchopulmonary dysplasia (BPD) in preterm infants. We systematically searched PubMed, EMBASE and the Cochrane Library. Two reviewers independently selected randomised controlled trials (RCTs) of postnatal corticosteroids in preterm infants. A Bayesian network meta-analysis and subgroup analyses were performed. We included 47 RCTs with 6747 participants. The use of dexamethasone at either high dose or low dose decreased the risk of BPD (OR 0.29, 95% credible interval (CrI) 0.14 to 0.52; OR 0.58, 95% CrI 0.39 to 0.76, respectively). High-dose dexamethasone was more effective than hydrocortisone, beclomethasone and low-dose dexamethasone. Early and long-term dexamethasone at either high dose or low dose decreased the risk of BPD (OR 0.11, 95% CrI 0.02 to 0.4; OR 0.37, 95% CrI 0.16 to 0.67, respectively). There were no statistically significant differences in the risk of cerebral palsy (CP) between different corticosteroids. However, high-dose and long-term dexamethasone ranked lower than placebo and other regimens in terms of CP. Subgroup analyses indicated budesonide was associated with a decreased risk of BPD in extremely preterm and extre...Continue Reading

References

May 1, 1993·Archives of Disease in Childhood·M A KariK O Raivio
Jun 13, 2001·American Journal of Respiratory and Critical Care Medicine·A H Jobe, E Bancalari
Feb 5, 2003·Biology of the Neonate·Katsumi TashiroBengt Robertson
Sep 28, 2004·Statistics in Medicine·G Lu, A E Ades
Nov 3, 2004·Pediatrics·Michele C WalshUNKNOWN National Institute of Child Health and Human Development Neonatal Research Network
Jun 14, 2006·Archives of Disease in Childhood. Fetal and Neonatal Edition·E S ShinwellB Reichman
Nov 9, 2007·The New England Journal of Medicine·Eugenio Baraldi, Marco Filippone
Nov 23, 2007·The New England Journal of Medicine·Rui WangJeffrey M Drazen
Dec 15, 2007·Journal of Child Neurology·Howard NeedelmanJ B Bodensteiner
Aug 25, 2010·Pediatrics·Barbara J StollUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Sep 8, 2010·Pediatrics·Kristi L Watterberg, UNKNOWN American Academy of Pediatrics. Committee on Fetus and Newborn
Dec 15, 2010·Pediatrics·Namasivayam AmbalavananUNKNOWN NICHD Neonatal Research Network
Mar 18, 2011·The Cochrane Database of Systematic Reviews·Sue HallIrene J Higginson
Jan 23, 2014·JAMA : the Journal of the American Medical Association·Xin SunGordon Guyatt

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Citations

Apr 8, 2018·Archives of Disease in Childhood. Fetal and Neonatal Edition·Henry L Halliday
Nov 15, 2018·Archives of Disease in Childhood. Fetal and Neonatal Edition·Sofia Dias, Deborah M Caldwell
Feb 12, 2019·Expert Review of Anti-infective Therapy·Bosco Paes, Xavier Carbonell-Estrany
Jan 22, 2019·Current Opinion in Pediatrics·Mark A Underwood
Apr 25, 2019·Journal of Paediatrics and Child Health·David Isaacs
Sep 17, 2019·Journal of Paediatrics and Child Health
Aug 5, 2020·The Annals of Otology, Rhinology, and Laryngology·Paul WistermayerDerek J Rogers
Apr 16, 2020·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Theodore DassiosAnne Greenough
Jul 22, 2020·Archives of Disease in Childhood. Fetal and Neonatal Edition·Ashok Kumar BuchiboyinaMary Sharp
May 31, 2018·BMC Pediatrics·Reem Al KhalifahLehana Thabane
Oct 10, 2019·American Journal of Physiology. Lung Cellular and Molecular Physiology·Ettore LignelliRory E Morty
Mar 30, 2019·Nature Reviews. Neuroscience·Aaron SathyanesanVittorio Gallo
May 10, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Christie ClaussCaterina Tiozzo
Jan 29, 2021·Seminars in Fetal & Neonatal Medicine·Souvik MitraBradley C Johnston
Mar 16, 2021·JAMA Pediatrics·Nehal A Parikh
May 1, 2021·Children·Tobias MuehlbacherManuel B Bryant
Dec 2, 2020·The Journal of Pediatrics·Nehal A ParikhUNKNOWN Cincinnati Infant Neurodevelopment Early Prediction Study (CINEPS) Investigators
May 30, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·Waleed KurtomNelson Claure
Aug 20, 2021·Pediatric Health, Medicine and Therapeutics·Marissa HennellySamia Aleem
Nov 3, 2021·Pediatric Research·Buse Özer BekmezEsra Çakır

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Methods Mentioned

BETA
PMA

Software Mentioned

WinBUGS
Cochrane
STATA

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