Steroid therapy for meconium aspiration syndrome in newborn infants

摘要: Background Meconium aspiration syndrome may cause severe respiratory distress in the newborn infant, with an associated high morbidity and mortality. A chemical pneumonitis is believed to occur secondary bile, bile acids pancreatic secretions contained meconium. It has therefore been hypothesised that corticosteroids be of benefit management this condition through their anti-inflammatory properties. Objectives The objective review was determine whether steroid therapy for meconium decreases mortality without adverse effects. Search methods Searches were made PREMEDLINE MEDLINE from 1966 April 2003, CINAHL back 1982, Current Contents 1998, The Cochrane Central Register Controlled Trials (CENTRAL, Library, Issue 1, 2003) Oxford Database Perinatal Trials. search included cross-referencing previous reviews, a abstracts, conference symposia proceedings published Pediatric Research 1993 2003. Selection criteria Randomised controlled trials quasi-randomised comparing treatment no neonates considered review. Data collection analysis The methodological quality each trial assessed independently by author. Data extracted, analysed results reviewed Meta-analysis performed RevMan 4.2, using fixed effects model. Mean difference (MD) weighted mean differences (WMD) 95% confidence intervals brackets continuous variables Relative Risk (RR) categorical data reported. Main results Three randomised identified. Two trials, Wu 1999 (50 participants) Yeh 1977 (35 participants), review. Davey 1995, as yet unpublished, excluded insufficient information about methodology available. On meta-analysis, there significant reduction [typical RR 0.95 (0.20, 4.58)]. small but increase duration oxygen seen use steroids [WMD 30.0 hours (8.4, 51.6)]. There hospital stay study [MD 0.00 days (-3.09, 3.09)]. Duration mechanical ventilation reported -1.10 (-2.79, 0.59)]. Incidence air leak detected [RR 0.64 (0.18, 2.26)]. Long-term outcome not either two studies. Authors' conclusions At present, evidence assess syndrome. further large assessing potential benefits harm would required its role.