Abstract | BACKGROUND: OBJECTIVES: To review the evidence from reported randomized controlled trials on the effects of postnatal corticosteroid on long-term mortality and motor dysfunction, including cerebral palsy. METHODS: The methods involved a meta-analysis of reported randomized controlled trials, following guidelines of the Cochrane Collaboration, including calculation of event rate differences (ERD) and 95% confidence intervals (CI). RESULTS: The mortality rate difference was non-significant both statistically and clinically (ERD - 0.1% favouring corticosteroids, 95% CI -2.9% to 2.8%). There were no subgroups in which a beneficial effect of postnatal corticosteroids on survival could be demonstrated. The rate of motor dysfunction in survivors was significantly higher in survivors from the postnatal corticosteroid group (ERD 11.9% favouring controls, 95% CI 4.6% to 19.2%). The rate of survival, free of motor dysfunction, was significantly lower in the postnatal corticosteroid group (ERD 7.8% favouring controls, 95% CI 0.5% to 15.1%). CONCLUSIONS: Although postnatal corticosteroids have short-term benefits, they do not increase the survival rate, and they may cause motor dysfunction in survivors. A large-scale, placebo-controlled randomized trial, with survival free of sensorineural impairments and disabilities as the major endpoint, is urgently needed.
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Authors | L Doyle, P Davis |
Journal | Journal of paediatrics and child health
(J Paediatr Child Health)
Vol. 36
Issue 2
Pg. 101-7
(Apr 2000)
ISSN: 1034-4810 [Print] Australia |
PMID | 10760004
(Publication Type: Journal Article, Meta-Analysis, Systematic Review)
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Chemical References |
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Topics |
- Adrenal Cortex Hormones
(adverse effects, therapeutic use)
- Cerebral Palsy
(chemically induced, mortality)
- Disease-Free Survival
- Female
- Humans
- Infant, Newborn
- Infant, Premature
- Motor Activity
(drug effects)
- Postnatal Care
- Randomized Controlled Trials as Topic
(statistics & numerical data)
- Survival Analysis
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