%0 Journal Article %1 Doyle2000 %A Doyle, L. %A Davis, P. %D 2000 %J J Paediatr Child Health %K Adrena; Cerebral Palsy; Disease-Free Survival; Female; Humans; Infant, Newborn; Premature; Motor Activity; Postnatal Care; Randomized Controlled Trials; Survival Analysis; l Cortex Hormones %N 2 %P 101--107 %T Postnatal corticosteroids in preterm infants: systematic review of effects on mortality and motor function. %V 36 %X BACKGROUND: Postnatal corticosteroid therapy has been proved in randomized controlled trials to reduce ventilator dependence and the rate of chronic lung disease in preterm infants with few serious short-term side effects. However, there are other consequences that might follow postnatal corticosteroid therapy that are more important, including mortality or cerebral palsy. 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.

@article{Doyle2000, abstract = {BACKGROUND: Postnatal corticosteroid therapy has been proved in randomized controlled trials to reduce ventilator dependence and the rate of chronic lung disease in preterm infants with few serious short-term side effects. However, there are other consequences that might follow postnatal corticosteroid therapy that are more important, including mortality or cerebral palsy. 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.}, added-at = {2014-07-19T19:23:18.000+0200}, author = {Doyle, L. and Davis, P.}, biburl = {https://www.bibsonomy.org/bibtex/2b0a7edced4a94f60baa16eacfb850810/ar0berts}, groups = {public}, interhash = {de8ac462927eac75bbb875f43517c82d}, intrahash = {b0a7edced4a94f60baa16eacfb850810}, journal = {J Paediatr Child Health}, keywords = {Adrena; Cerebral Palsy; Disease-Free Survival; Female; Humans; Infant, Newborn; Premature; Motor Activity; Postnatal Care; Randomized Controlled Trials; Survival Analysis; l Cortex Hormones}, month = Apr, number = 2, pages = {101--107}, pii = {jpc481}, pmid = {10760004}, timestamp = {2014-07-19T19:23:18.000+0200}, title = {Postnatal corticosteroids in preterm infants: systematic review of effects on mortality and motor function.}, username = {ar0berts}, volume = 36, year = 2000 }