Table 1 Main benefits and risks of the individual patient data meta-analysis of neonates exposed to prophylactic hydrocortisone recruited in randomized controlled trials from 2001 and 2014 (adapted from Shaffer et al.).

From: Prophylactic low-dose hydrocortisone in neonates born extremely preterm: current knowledge and future challenges

Outcome

n/N (%)

aOR (95% CI)

P-value

I²

NNT/NNH

Comment

 

Hydrocortisone

Placebo

     

Benefits

 Survival without BPD

258/484 (53.3)

225/495 (45.5)

1.45 (1.11–1.90)

0.007

0%

13

NNT = 6 when adjusted to baseline characteristics.25

 BPD at 36 weeks PMA

147/405 (36.3)

172/397 (43.3)

0.73 (0.54–0.98)

0.038

0%

14

BPD at 40 weeks PMA significantly prevented by early hydrocortisone as well.32

 Death before discharge

85/485 (17.5)

112/497 (22.5)

0.70 (0.51–0.97)

0.033

0%

20

 

Medical treatment for PDA

202/485 (41.7)

246/497 (49.5)

0.72 (0.56–0.93)

0.012

0%

13

 

Risks

 Spontaneous intestinal perforation

35/483 (7.3)

15/497 (3.0)

2.50 (1.33–4.69)

0.004

32%

24

Observed neither in the PREMILOC trial nor in real-world data.48,49,50

 Late onset sepsis

176/485 (36.3)

148/497 (29.8)

1.34 (1.02–1.75)

0.04

0%

15

Without any detectable negative impact on BPD, death or NDI.24

  1. aOR Odds Ratios adjusted for sex, gestational age and antenatal steroids, I² summarizes the statistical heterogeneity, NNT number needed to treat, NNH number needed to harm, BPD Bronchopulonary dysplasia, PDA patent ductus arteriosus.
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