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Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 1 CLD at 36 weeks PMA.
Figures and Tables -
Analysis 1.1

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 1 CLD at 36 weeks PMA.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 2 CLD at 28 days of age.
Figures and Tables -
Analysis 1.2

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 2 CLD at 28 days of age.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 3 Death by 28 days of age.
Figures and Tables -
Analysis 1.3

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 3 Death by 28 days of age.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 4 Death by 36 weeks PMA.
Figures and Tables -
Analysis 1.4

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 4 Death by 36 weeks PMA.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 5 Death by or CLD at 28 days of age.
Figures and Tables -
Analysis 1.5

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 5 Death by or CLD at 28 days of age.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 6 Death by or CLD at 36 weeks PMA.
Figures and Tables -
Analysis 1.6

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 6 Death by or CLD at 36 weeks PMA.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 7 Requirement for systemic steroids.
Figures and Tables -
Analysis 1.7

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 7 Requirement for systemic steroids.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 8 Failure to extubate within 14 days.
Figures and Tables -
Analysis 1.8

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 8 Failure to extubate within 14 days.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 9 Infection.
Figures and Tables -
Analysis 1.9

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 9 Infection.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 10 Hyperglycemia.
Figures and Tables -
Analysis 1.10

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 10 Hyperglycemia.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 11 Hypertension.
Figures and Tables -
Analysis 1.11

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 11 Hypertension.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 12 Gastrointesinal bleeding.
Figures and Tables -
Analysis 1.12

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 12 Gastrointesinal bleeding.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 13 Cataract.
Figures and Tables -
Analysis 1.13

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 13 Cataract.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 14 Intraventricular hemorrhage.
Figures and Tables -
Analysis 1.14

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 14 Intraventricular hemorrhage.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 15 Periventricular leucomalacia.
Figures and Tables -
Analysis 1.15

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 15 Periventricular leucomalacia.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 16 Necrotizing enterocolitis.
Figures and Tables -
Analysis 1.16

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 16 Necrotizing enterocolitis.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 17 Retinopathy of prematurity.
Figures and Tables -
Analysis 1.17

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 17 Retinopathy of prematurity.

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 18 Patent ductus arteriosus.
Figures and Tables -
Analysis 1.18

Comparison 1 Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized), Outcome 18 Patent ductus arteriosus.

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 1 CLD at 36 weeks PMA.
Figures and Tables -
Analysis 2.1

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 1 CLD at 36 weeks PMA.

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 2 CLD at 28 days of age.
Figures and Tables -
Analysis 2.2

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 2 CLD at 28 days of age.

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 3 Cerebral palsy.
Figures and Tables -
Analysis 2.3

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 3 Cerebral palsy.

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 4 Mean developmental index on BSID‐II < 2 SD of the mean.
Figures and Tables -
Analysis 2.4

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 4 Mean developmental index on BSID‐II < 2 SD of the mean.

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 5 Respiratory readmission.
Figures and Tables -
Analysis 2.5

Comparison 2 Early inhaled steroid (< 2 weeks) vs. placebo (among survivors), Outcome 5 Respiratory readmission.

Comparison 1. Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 CLD at 36 weeks PMA Show forest plot

5

429

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.62, 1.52]

2 CLD at 28 days of age Show forest plot

5

429

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.84, 1.32]

3 Death by 28 days of age Show forest plot

5

429

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.39, 1.14]

4 Death by 36 weeks PMA Show forest plot

5

429

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.44, 1.21]

5 Death by or CLD at 28 days of age Show forest plot

5

429

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.80, 1.14]

6 Death by or CLD at 36 weeks PMA Show forest plot

5

429

Risk Ratio (M‐H, Fixed, 95% CI)

0.86 [0.63, 1.17]

7 Requirement for systemic steroids Show forest plot

6

461

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.69, 1.02]

8 Failure to extubate within 14 days Show forest plot

5

193

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.76, 1.24]

9 Infection Show forest plot

3

116

Risk Ratio (M‐H, Fixed, 95% CI)

1.12 [0.60, 2.09]

10 Hyperglycemia Show forest plot

3

116

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.49, 1.44]

11 Hypertension Show forest plot

3

116

Risk Ratio (M‐H, Fixed, 95% CI)

1.20 [0.36, 3.99]

12 Gastrointesinal bleeding Show forest plot

1

253

Risk Ratio (M‐H, Fixed, 95% CI)

0.35 [0.04, 3.34]

13 Cataract Show forest plot

1

253

Risk Ratio (M‐H, Fixed, 95% CI)

0.35 [0.01, 8.56]

14 Intraventricular hemorrhage Show forest plot

2

306

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.77, 1.41]

15 Periventricular leucomalacia Show forest plot

2

306

Risk Ratio (M‐H, Fixed, 95% CI)

1.43 [0.59, 3.46]

16 Necrotizing enterocolitis Show forest plot

2

306

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.41, 1.08]

17 Retinopathy of prematurity Show forest plot

2

306

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.87, 1.15]

18 Patent ductus arteriosus Show forest plot

1

53

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.57, 1.17]

Figures and Tables -
Comparison 1. Early inhaled steroids (< 2 weeks) vs. placebo (among all randomized)
Comparison 2. Early inhaled steroid (< 2 weeks) vs. placebo (among survivors)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 CLD at 36 weeks PMA Show forest plot

5

362

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.57, 1.41]

2 CLD at 28 days of age Show forest plot

5

380

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.78, 1.21]

3 Cerebral palsy Show forest plot

1

56

Risk Ratio (M‐H, Fixed, 95% CI)

1.33 [0.33, 5.42]

4 Mean developmental index on BSID‐II < 2 SD of the mean Show forest plot

1

56

Risk Ratio (M‐H, Fixed, 95% CI)

1.25 [0.37, 4.17]

5 Respiratory readmission Show forest plot

1

56

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.44, 2.29]

Figures and Tables -
Comparison 2. Early inhaled steroid (< 2 weeks) vs. placebo (among survivors)