Review: moderately early postnatal corticosteroids reduce chronic lung disease and mortality in preterm infants, but increase complications
QUESTIONS: Is moderately early postnatal corticosteroid (PC) treatment given 7–14 days after birth effective for prevention and treatment of chronic lung disease (CLD) in at risk, preterm infants? Do PCs increase the risk of adverse effects?
Studies were identified by searching the Oxford Database of Perinatal Trials, the Cochrane Controlled Trials Register, and Medline (1966 to September 2000); handsearching paediatric and perinatal journals; examining review articles; and contacting practising neonatologists.
Randomised controlled trials were selected if they compared systemic PC treatment given 7–14 days after birth with control (placebo or nothing) in preterm infants with or at risk of developing CLD.
Data were extracted on study methods, participant characteristics, and outcomes.
7 trials (8 treatment arms) were included in the analysis. The trials involved very low birthweight infants who were receiving mechanical ventilation; the corticosteroid was dexamethasone, with a …