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Inhaled Corticosteroids for Bronchopulmonary Dysplasia: A Meta-analysis
Eric S Shinwell1, Igor Portnov2, Joerg J Meerpohl3
1Department of Neonatology, Ziv Medical Center, Faculty of Medicine in the Galil, Bar-Ilan University, Tsfat, Israel; eric.s@ziv.health.gov.il.
Pediatrics
|December 13, 2016
Summary
Inhaled corticosteroids (IC) significantly reduce bronchopulmonary dysplasia (BPD) in preterm infants without increasing mortality. Further research is needed on long-term outcomes.
Area of Science:
- Neonatal Medicine
- Respiratory Medicine
- Pharmacology
Background:
- Bronchopulmonary dysplasia (BPD) poses a significant health challenge for preterm infants.
- Inhaled corticosteroids (IC) are being explored as a potential therapeutic intervention for BPD.
Purpose of the Study:
- To evaluate the safety and efficacy of IC for preventing or treating BPD or death in preterm infants.
Main Methods:
- A meta-analysis was conducted on randomized controlled trials comparing ICs with placebo.
- Data were extracted from PubMed, Cochrane Library, Embase, and CINAHL up to November 2015.
- The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess evidence quality.
Main Results:
- Sixteen trials involving 1285 infants met inclusion criteria.
- ICs significantly reduced the combined outcome of death or BPD at 36 weeks' postmenstrual age (RR 0.86, 95% CI 0.75 to 0.99).
- BPD was significantly reduced (RR 0.77, 95% CI 0.65 to 0.91), with no significant effect on mortality.
- Systemic steroid use was also reduced in infants receiving ICs.
Conclusions:
- Inhaled corticosteroids appear beneficial for very preterm infants, reducing BPD risk without adverse effects on mortality or other morbidities.
- Long-term respiratory, growth, and developmental outcomes require further investigation.
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