Review: early postnatal corticosteroids reduce chronic lung disease in preterm infants, but increase complications
QUESTIONS: Does early postnatal corticosteroid (PC) treatment given within the first 96 hours of birth decrease the risk 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 intravenous PC treatment given within 96 hours of birth with control (placebo or nothing) in preterm infants at risk of developing CLD.
Data were extracted on study methods, participant characteristics, and outcomes.
19 trials were included in the analysis. Most trials involved low birthweight infants with respiratory distress syndrome (RDS) who were receiving mechanical ventilation. The most common treatment assessed was dexamethasone, 0.50 mg/kg/day for 3 days, followed by 0.25 mg/kg/day for 3 …