The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment
<i>Background and Objectives</i>: Meconium aspiration syndrome (MAS) is a condition caused by the aspiration of meconium-stainted amniotic fluid into the lungs, resulting in pulmonary inflammation, neonatal morbidity, and mortality. It is important that these MAS infants receive appropri...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/11/1281 |
| _version_ | 1797509457361502208 |
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| author | Nanthida Phattraprayoon Teerapat Ungtrakul Wimonchat Tangamornsuksan |
| author_facet | Nanthida Phattraprayoon Teerapat Ungtrakul Wimonchat Tangamornsuksan |
| author_sort | Nanthida Phattraprayoon |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Meconium aspiration syndrome (MAS) is a condition caused by the aspiration of meconium-stainted amniotic fluid into the lungs, resulting in pulmonary inflammation, neonatal morbidity, and mortality. It is important that these MAS infants receive appropriate care to avoid further complications. Steroids have an anti-inflammatory effect and may be effective in the management of MAS. The objective of the this study was to evaluate the effect of different steroids on clinical outcomes in infants with MAS. <i>Materials and Methods</i>: We systematically searched of PubMed/Medline, Scopus, Embase, Clinical Trials.gov, and Cochrane Library databases from inception to 24 January 2021 without language restriction. Only randomized controlled trials (RCTs) evaluating the effects of steroids in neonates with MAS were included. We calculated relative risks and weighted mean differences (MDs) with 95% confidence intervals (CIs) using a random-effects model to determine the associations between MAS and steroids and GRADE approach was employed for quality of evidence. The main outcomes measures were duration of respiratory distress, oxygen requirement, hospitalization, need for mechanical ventilation, death, and adverse drug reactions. <i>Results</i>: Seven RCTs involving 397 patients were analyzed. Nebulized budesonide and intravenous (IV) methylprednisolone shortened the duration of respiratory distress (MD, −2.46 days; 95% CI, −3.09 to −1.83 and MD, −3.30 days; 95% CI, −4.07 to −2.52, respectively) (moderate certainty). There was a reduction in duration of oxygen requirement in nebulized budesonide use (MD, −2.40 days; 95% CI, −3.40 to −1.40) (low certainty) and IV methylprednisolone use (MD, −3.30 days; 95% CI, −4.07 to −2.52) (moderate certainty). Nebulized budesonide shortened hospitalization stay (MD, −4.47 days; 95% CI, −8.64 to −0.30 days) (low certainty) as IV methylprednisolone use (MD, −7.23 days; 95% CI, −8.19 to −6.07 days) (moderate certainty). None of steroids benefits in death (low certainty). <i>Conclusions</i>: Certain types of steroids may benefit the respiratory aspect, but there was no decrease in mortality in MAS infants. |
| first_indexed | 2024-03-10T05:18:02Z |
| format | Article |
| id | doaj.art-9c8821686a78447e84984d72a72b4c13 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T05:18:02Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj.art-9c8821686a78447e84984d72a72b4c132023-11-23T00:18:29ZengMDPI AGMedicina1010-660X1648-91442021-11-015711128110.3390/medicina57111281The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE AssessmentNanthida Phattraprayoon0Teerapat Ungtrakul1Wimonchat Tangamornsuksan2Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok 10210, ThailandFaculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok 10210, ThailandFaculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok 10210, Thailand<i>Background and Objectives</i>: Meconium aspiration syndrome (MAS) is a condition caused by the aspiration of meconium-stainted amniotic fluid into the lungs, resulting in pulmonary inflammation, neonatal morbidity, and mortality. It is important that these MAS infants receive appropriate care to avoid further complications. Steroids have an anti-inflammatory effect and may be effective in the management of MAS. The objective of the this study was to evaluate the effect of different steroids on clinical outcomes in infants with MAS. <i>Materials and Methods</i>: We systematically searched of PubMed/Medline, Scopus, Embase, Clinical Trials.gov, and Cochrane Library databases from inception to 24 January 2021 without language restriction. Only randomized controlled trials (RCTs) evaluating the effects of steroids in neonates with MAS were included. We calculated relative risks and weighted mean differences (MDs) with 95% confidence intervals (CIs) using a random-effects model to determine the associations between MAS and steroids and GRADE approach was employed for quality of evidence. The main outcomes measures were duration of respiratory distress, oxygen requirement, hospitalization, need for mechanical ventilation, death, and adverse drug reactions. <i>Results</i>: Seven RCTs involving 397 patients were analyzed. Nebulized budesonide and intravenous (IV) methylprednisolone shortened the duration of respiratory distress (MD, −2.46 days; 95% CI, −3.09 to −1.83 and MD, −3.30 days; 95% CI, −4.07 to −2.52, respectively) (moderate certainty). There was a reduction in duration of oxygen requirement in nebulized budesonide use (MD, −2.40 days; 95% CI, −3.40 to −1.40) (low certainty) and IV methylprednisolone use (MD, −3.30 days; 95% CI, −4.07 to −2.52) (moderate certainty). Nebulized budesonide shortened hospitalization stay (MD, −4.47 days; 95% CI, −8.64 to −0.30 days) (low certainty) as IV methylprednisolone use (MD, −7.23 days; 95% CI, −8.19 to −6.07 days) (moderate certainty). None of steroids benefits in death (low certainty). <i>Conclusions</i>: Certain types of steroids may benefit the respiratory aspect, but there was no decrease in mortality in MAS infants.https://www.mdpi.com/1648-9144/57/11/1281different types of steroidsmeconium aspiration syndromeclinical outcomessystematic review and meta-analysis |
| spellingShingle | Nanthida Phattraprayoon Teerapat Ungtrakul Wimonchat Tangamornsuksan The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment Medicina different types of steroids meconium aspiration syndrome clinical outcomes systematic review and meta-analysis |
| title | The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment |
| title_full | The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment |
| title_fullStr | The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment |
| title_full_unstemmed | The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment |
| title_short | The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment |
| title_sort | effects of different types of steroids on clinical outcomes in neonates with meconium aspiration syndrome a systematic review meta analysis and grade assessment |
| topic | different types of steroids meconium aspiration syndrome clinical outcomes systematic review and meta-analysis |
| url | https://www.mdpi.com/1648-9144/57/11/1281 |
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