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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Autores principales:	Nanthida Phattraprayoon, Teerapat Ungtrakul, Wimonchat Tangamornsuksan
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	different types of steroids meconium aspiration syndrome clinical outcomes systematic review and meta-analysis Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/9c8821686a78447e84984d72a72b4c13
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spelling	oai:doaj.org-article:9c8821686a78447e84984d72a72b4c132021-11-25T18:19:13ZThe Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment10.3390/medicina571112811648-91441010-660Xhttps://doaj.org/article/9c8821686a78447e84984d72a72b4c132021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1281https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<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.Nanthida PhattraprayoonTeerapat UngtrakulWimonchat TangamornsuksanMDPI AGarticledifferent types of steroidsmeconium aspiration syndromeclinical outcomessystematic review and meta-analysisMedicine (General)R5-920ENMedicina, Vol 57, Iss 1281, p 1281 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	different types of steroids meconium aspiration syndrome clinical outcomes systematic review and meta-analysis Medicine (General) R5-920
spellingShingle	different types of steroids meconium aspiration syndrome clinical outcomes systematic review and meta-analysis Medicine (General) R5-920 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
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.
format	article
author	Nanthida Phattraprayoon Teerapat Ungtrakul Wimonchat Tangamornsuksan
author_facet	Nanthida Phattraprayoon Teerapat Ungtrakul Wimonchat Tangamornsuksan
author_sort	Nanthida Phattraprayoon
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_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_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_sort	effects of different types of steroids on clinical outcomes in neonates with meconium aspiration syndrome: a systematic review, meta-analysis and grade assessment
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/9c8821686a78447e84984d72a72b4c13
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The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment

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