Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries—A systematic review and meta-analysis of RCTs

Mangesh Deshmukh and Sanjay Patole

PLOS ONE, 2021, vol. 16, issue 3, 1-15

Abstract: Background: Administration of antenatal corticosteroids (ANC) for impending preterm delivery beyond 34 weeks of gestation continues to be a controversial issue despite various guidelines for obstetricians and gynaecologists. Objective: To compare outcomes following exposure to ANC for infants born between 34–36+6 weeks’ gestation. Methods: A systematic review of randomised controlled trials (RCT) reporting neonatal outcomes after ANC exposure between 34–36+6 weeks’ gestation using Cochrane methodology. Databases including PubMed, Embase, Emcare, Cochrane Central library and Google Scholar were searched in May 2020. Primary outcomes: (1) Need for respiratory support (Mechanical ventilation, CPAP, high flow) or oxygen (2) Hypoglycemia. Secondary outcomes included respiratory distress syndrome (RDS), transient tachypnoea of newborn (TTN), need for neonatal resuscitation at birth [only in the delivery room immediately after birth (not in neonatal intensive care unit (NICU)], admission to NICU, mortality and developmental follow up. Level of evidence (LOE) was summarised by GRADE guidelines. Main results: Seven RCTs (N = 4144) with low to high risk of bias were included. Only one RCT was from high income countries, Meta-analysis (random-effects model) showed (1) reduced need for respiratory support [5 RCTs (N = 3844); RR = 0.68 (0.47–0.98), p = 0.04; I2 = 55%; LOE: Moderate] and (2) higher risk of neonatal hypoglycaemia [4 RCTs (N = 3604); RR = 1.61(1.38–1.87), p

Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0248774

DOI: 10.1371/journal.pone.0248774

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