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Figure 1. Flow of inclusion randomised controlled trials in different phases of search.
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Figure 1

Figure 1. Flow of inclusion randomised controlled trials in different phases of search.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 1 Mortality at 28 days PNA.
Figures and Tables -
Analysis 1.1

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 1 Mortality at 28 days PNA.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 2 Mortality at 36 weeks PMA.
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Analysis 1.2

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 2 Mortality at 36 weeks PMA.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 3 Mortality at hospital discharge.
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Analysis 1.3

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 3 Mortality at hospital discharge.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 4 Bronchopulmonary dysplasia at 28 days PNA.
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Analysis 1.4

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 4 Bronchopulmonary dysplasia at 28 days PNA.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 5 Bronchopulmonary dysplasia at 36 weeks PMA.
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Analysis 1.5

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 5 Bronchopulmonary dysplasia at 36 weeks PMA.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 6 Combined outcome mortality and bronchopulmonary dysplasia at 28 days PNA.
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Analysis 1.6

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 6 Combined outcome mortality and bronchopulmonary dysplasia at 28 days PNA.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 7 Combined outcome mortality or bronchopulmonary dysplasia at 36 weeks PMA.
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Analysis 1.7

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 7 Combined outcome mortality or bronchopulmonary dysplasia at 36 weeks PMA.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 8 Failure to extubate day 7.
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Analysis 1.8

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 8 Failure to extubate day 7.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 9 Failure to extubate day 14.
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Analysis 1.9

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 9 Failure to extubate day 14.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 10 Failure to extubate at the latest reported moment.
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Analysis 1.10

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 10 Failure to extubate at the latest reported moment.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 11 Days of mechanical ventilation.
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Analysis 1.11

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 11 Days of mechanical ventilation.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 12 Days of supplemental oxygen.
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Analysis 1.12

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 12 Days of supplemental oxygen.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 13 Open label intravenous glucocorticoids.
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Analysis 1.13

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 13 Open label intravenous glucocorticoids.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 14 Sepsis (clinical suspected or culture proven).
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Analysis 1.14

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 14 Sepsis (clinical suspected or culture proven).

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 15 Persistent ductus arteriosus.
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Analysis 1.15

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 15 Persistent ductus arteriosus.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 16 Hypertension (> 2 SD).
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Analysis 1.16

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 16 Hypertension (> 2 SD).

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 17 Necrotising enterocolitis.
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Analysis 1.17

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 17 Necrotising enterocolitis.

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 18 Intraventricular haemorrhage (any grade).
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Analysis 1.18

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 18 Intraventricular haemorrhage (any grade).

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 19 Days of hospitalisation.
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Analysis 1.19

Comparison 1 Inhaled glucocorticoids versus placebo, Outcome 19 Days of hospitalisation.

Comparison 1. Inhaled glucocorticoids versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality at 28 days PNA Show forest plot

2

51

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.14, 65.90]

1.1 Ventilated infants

2

41

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.14, 65.90]

1.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Mortality at 36 weeks PMA Show forest plot

3

61

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.35, 25.78]

2.1 Ventilated infants

3

51

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.35, 25.78]

2.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Mortality at hospital discharge Show forest plot

3

53

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.35, 25.78]

3.1 Ventilated infants

3

43

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.35, 25.78]

3.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Bronchopulmonary dysplasia at 28 days PNA Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.72, 1.21]

4.1 Ventilated infants

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.61, 1.29]

4.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.71, 1.41]

5 Bronchopulmonary dysplasia at 36 weeks PMA Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.59, 1.70]

5.1 Ventilated infants

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

1.14 [0.69, 1.90]

5.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.06, 3.91]

6 Combined outcome mortality and bronchopulmonary dysplasia at 28 days PNA Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.85, 1.18]

6.1 Ventilated infants

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.83, 1.20]

6.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.71, 1.41]

7 Combined outcome mortality or bronchopulmonary dysplasia at 36 weeks PMA Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

1.10 [0.74, 1.63]

7.1 Ventilated infants

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

1.24 [0.87, 1.75]

7.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.06, 3.91]

8 Failure to extubate day 7 Show forest plot

5

79

Risk Ratio (M‐H, Random, 95% CI)

0.85 [0.62, 1.18]

9 Failure to extubate day 14 Show forest plot

2

27

Risk Ratio (M‐H, Fixed, 95% CI)

0.36 [0.10, 1.33]

10 Failure to extubate at the latest reported moment Show forest plot

6

90

Risk Ratio (M‐H, Random, 95% CI)

0.57 [0.27, 1.20]

11 Days of mechanical ventilation Show forest plot

3

45

Mean Difference (IV, Random, 95% CI)

2.79 [‐3.47, 9.06]

12 Days of supplemental oxygen Show forest plot

4

141

Mean Difference (IV, Fixed, 95% CI)

0.57 [‐5.92, 7.07]

12.1 Ventilated infants

4

100

Mean Difference (IV, Fixed, 95% CI)

5.53 [‐3.99, 15.05]

12.2 Non‐ventilated infants

2

41

Mean Difference (IV, Fixed, 95% CI)

‐3.74 [‐12.63, 5.14]

13 Open label intravenous glucocorticoids Show forest plot

4

74

Risk Ratio (M‐H, Fixed, 95% CI)

0.51 [0.26, 1.00]

13.1 Ventilated infants

4

64

Risk Ratio (M‐H, Fixed, 95% CI)

0.51 [0.26, 1.00]

13.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

14 Sepsis (clinical suspected or culture proven) Show forest plot

5

107

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.50, 1.64]

14.1 Ventilated infants

5

97

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.44, 1.77]

14.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.36, 2.75]

15 Persistent ductus arteriosus Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.16, 6.20]

15.1 Ventilated infants

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.16, 6.20]

16 Hypertension (> 2 SD) Show forest plot

1

27

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

16.1 Ventilated infants

1

17

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

16.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

17 Necrotising enterocolitis Show forest plot

1

27

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

17.1 Ventilated infants

1

17

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

17.2 Non‐ventilated infants

1

10

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

18 Intraventricular haemorrhage (any grade) Show forest plot

1

19

Risk Ratio (M‐H, Fixed, 95% CI)

0.6 [0.13, 2.82]

18.1 Ventilated infants

1

19

Risk Ratio (M‐H, Fixed, 95% CI)

0.6 [0.13, 2.82]

19 Days of hospitalisation Show forest plot

1

18

Mean Difference (IV, Fixed, 95% CI)

‐24.70 [‐41.75, ‐7.65]

19.1 Ventilated infants

1

18

Mean Difference (IV, Fixed, 95% CI)

‐24.70 [‐41.75, ‐7.65]

Figures and Tables -
Comparison 1. Inhaled glucocorticoids versus placebo