Evidence map›Paper›PMID 39223342›Full record

SynthesisJournal of perinatology : official journal of the California Perinatal Association2026

Systemic steroids and bronchopulmonary dysplasia: a systematic review and meta-analysis.

Talkad S Raghuveer, Rosey E Zackula, Richa Lakhotia, Stephanie A Binder

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Do systemic steroids impact survival free of cerebral palsy in preterm infants at risk for bronchopulmonary dysplasia?Journal of perinatology : official journal of the California Perinatal Association · 2026
    Article
  2. Review
  3. Do Postnatal Corticosteroids Negatively Impact the Neurodevelopmental Outcomes of Extremely Preterm Infants?The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025
    Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Talkad S RaghuveerDepartment of Pediatrics, University of Kansas School of Medicine-Wichita, Wichita, KS, USA. raghuveer.talkad3@gmail.com.ORCID http://orcid.org/0000-0001-6482-9684
Rosey E ZackulaOffice of Research, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.ORCID http://orcid.org/0000-0003-2439-8714
Richa LakhotiaDepartment of Pediatrics, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.
Stephanie A BinderDepartment of Pediatrics, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

importanceIt is unclear if systemic steroids decrease the risk of Bronchopulmonary Dysplasia (BPD) while increasing the risk of neurodevelopmental impairment (NDI).

objectiveConduct a systematic review of randomized controlled trials of systemic steroids to evaluate the risk of BPD, mortality, and NDI in premature infants ≤30 weeks. DATA SOURCES: MEDLINE, EBSCOhost, Web of Science, Cochrane Library, Embase, and CINAHL. STUDY SELECTION: Randomized clinical trials of Dexamethasone (DEX) or Hydrocortisone (HC) to prevent BPD in premature infants ≤ 30 weeks. DATA EXTRACTION AND SYNTHESIS: Data were extracted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Random-effects meta-analyses and multivariable meta-regression were conducted. MAIN OUTCOMES AND MEASURES: Primary outcomes were BPD, mortality, and NDI. Secondary outcomes were hypertension, hyperglycemia, sepsis, intestinal perforation, necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP). The a priori hypothesis was that steroids would reduce the risk of BPD without increasing NDI.

resultsThere were 6377 preterm infants in the 44 (32 DEX, 13 HC) selected studies. DEX significantly reduced the risk of BPD, RR = 0.66, (95% CI, 0.56-0.78). The most effective DEX regimen was medium cumulative dose (2 to 3 mg/kg), RR = 0.43 (95% CI, 0.29-0.65); day of initiation <8 days: RR = 0.68, (95% CI, 0.59-0.79); and treatment for ≥14 days: RR = 0.67 (95% CI, 0.55-0.80). HC did not significantly decrease the risk of BPD, RR = 0.98, (95% CI, 0.87-1.10). Neither DEX, (RR = 0.92, 95% CI, 0.78-1.09) nor HC (RR = 0.83, 95% CI, 0.68-1.01) decrease the risk of mortality. The risk of CP was not increased by either DEX (RR = 1.09, 95% CI, 0.55-2.17) or HC (RR = 1.18, 95% CI, 0.75-1.87). There were no significant differences between steroids and placebo for MDI/PDI scores. Multivariable meta-regression models showed that DEX significantly reduced the risk of BPD without increased risk of CP. DEX increased the risk of hypertension and hyperglycemia. Studies showed high heterogeneity, differing treatment regimen, missing data and different rates of follow-up. CONCLUSION AND RELEVANCE: DEX, but not HC, significantly decreased the risk of BPD. Neither steroid showed an increased risk of NDI or mortality.

Indexed as

Bronchopulmonary DysplasiaDexamethasoneGlucocorticoidsHydrocortisoneNeurodevelopmental DisordersHumansInfant, NewbornInfant, PrematureRandomized Controlled Trials as TopicDexamethasoneGlucocorticoidsHydrocortisone

Identifiers

PMID39223342

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.