childhood (FWMD 0.30 kg, 95% Data were available for several of the ry outcomes that relate CI-0.39 to 1.00 kg, two studies, 333 children), height( FWMd to the mother and fetus or neonate for pregnancies complicated by 1.02 cm, 95%CI -0 26 to 2.29 cm, two studies, 334 children), multiple birth. However most of these were from just two studies head circumference(FWMD 0 27 cm, 95%CI-008 to 0.63 cm, ( Collaborative 1981: Liggins 1972b). No statistically significant two studies, 328 children), lung function(vital capacity FWMd differences between groups treated with antenatal corticosteroids 1.68% predicted, 95%CI-512 to 1.75 predicted, two stud.(in women with multiple pregnancies)and controls were seen for ies, 150 children), systolic blood pressure(FWMD-1. 60 mmHg, chorioamnionitis(RR 0.48, 95% CI 0.04 to 4.49, one study, 74 95%CI-4.06 to 0.86 mmHg, one study, 223 children), visual women), fetal death(RR 0.53, 95%CI 0.20 to 1.40, two studies, impairment(RR 0.55, 95%CI 0. 24 to 1. 23, two studies, 166 252 infants), neonatal death(RR 0.79, 95%CI 0.39 to 1.61 children), hearing impairment(RR 0.64, 95% CI 0.04 to 9.87, two studies, 236 infants), RDS(RR 0.85, 95%CI 0.60 to 1.20, two studies, 166 children), behavioural/learning difficulties(rr four studies, 320 infants, cerebroventricular haemorrhage(RR 0.86,95%CI 0.35 to 2.09, one study, 90 children)or intellectual 0.39, 95%CI 0.07 to 2.06, one study, 137 infants)or birthweight impairment(RR 0.86, 95%CI 0.44 to 1.69, three studies, 778 (FWMD 82.36 grams, 95%Cl-14623 to 310.95 grams, one study, 150 infants), although the RRs were similar to those in For the the overall analysis, though small numbers meant the confidence One study(Liggins 1972b) showed increased insulin tervals were wide and crossed one (FWMD 0 16 log insulin units, 95% CI 0.04 to 0. 28 log insulin gestational age at deliery Dzas Placebo or no treatment(by minutes following a fasting 75 g oral glucose tolerance tes Antenatal corticosteroids units,one study, 412 adults)in 30 year olds who had been ex- Data were available by gestational age at delivery for several of the posed to antenatal corticosteroid. However, the study reported no primary outcomes that relate to the mother and fetus or neonate difference between those exposed to antenatal corticosteroids and Combined fetal and neonatal death was significantly reduced controls in the prevalence of diabetes. No statistically significant corticosteroid treated infants born before 32 weeks(RRO.71,95% differences between those exposed to antenatal corticosteroids and CI0.57 to 0.88, three studies, 453 infants), before 34 weeks(RR controls were seen for weight(FWMD 0.80 kg, 95%CI-2.02 to 0.73, 95%CI 0.58 to 0.91, one study, 598 infants)and before 36 3. 62 kg, two studies, 538 adults ), height(FWMD 0.91 cm,95% weeks(RR 0.75, 95%CI 0.61 to 0.94, two studies, 969 infants) CI-0.28 to 2.10 cm, two studies, 537 adults), head circumference but not in those born before 28 weeks(RR 0.81, 95%CI 0.65 (FWMD 0.03 cm, 95% CI -0.33 to 0.38 cm, two studies, 537 to 1.01, two studies, 129 infants), before 30 weeks(RR 0.86, adults),skinfold thickness(triceps FWMD-002 log units, 95% 95%CI 0.70 to 1.05,one study, 201 infants)and at a gestation CI-0.11 to 0.07 log units, one study, 456 adults ) systolic blood of at least 34 weeks(RR 1. 13,95%C1 0.66 to 1.96, one study pressure(FWMD-087 mmHg, 95%CI-2.81 to 1.07 mmHg, 770 infants). In infants born at a gestation of at least 36 weeks two studies, 545 adults), HPA axis function(Cortisol FWMD there was a non-significant trend towards an increase in combined 0.06 log units, 95% CI-002 to 0. 14 log units, one study, 444 fetal and neonatal death(Rr 3.25, 95% CI 0.99 to 10.66,two dults ), cholesterol(FWMD-O 11 mmol/L, 95%CI-0 28 to 0.06 studies, 498 infants). Neonatal death was significantly reduced mmol/L,one study, 445 adults), age at puberty(FWMD for fe- in corticosteroid treated infants born before 32 weeks(RR O59 males years, 95%CI-094 to 0.94 years, one study, 38 adults), 95% CI 0.43 to 0.80, three studies, 378 infants), before 34 weeks ducational attainment(RR0.94,95%C1 0.80 to 1.10, one study, (RR 0.69,95% CI 0.52 to 0. 92, two studies, 715 infants)and 534 adults), visual impairment(RR 0.91, 95%CI 0.53 to 1.55, before 36 weeks(RR O68, 95%CI 0.50 to 0.92, two studies, 869 one study, 192 adults), hearing impairment(RR 0.24, 95%CI infants), but not in those born before 28 weeks(RRO.79,95%CI 0.03 to 2.03, one study, 192 adults)or intellectual impairment 0.56 to 1. 12, two studies, 89 infants), before 30 weeks(RR 0.82, (RR 0.24, 95%CI 0.01 to 4.95, two studies, 273 adults) 95%CI 0.60 to 1.11, one study, 150 infants), at a gestation of at least 34 weeks(RR 1.58, 95% CI 0.71 to 3.50, two studies, 808 For the health services infants), and at a gestation of at least 36 weeks(rr 2.62, 95%CI No statistically significant differences between groups treated with 0.77 to 8.96, three studies, 514 infants) natal corticosteroids and controls were seen for length of ante natal hospitalisation for women(FWMD 0.50 days, 95%CI-1.40 RDS was significantly reduced in corticosteroid treated infants to 2. 40 days, one study, 218 women ), postnatal hospitalisation for born before 30 weeks(RRO. 67 95%C10. 52 to 0. 87, four studies, men(FWMD 0.00 days, 95%CI-1.72 to 1.72 days, one stuc 218 women)or neonatal hospitalisation for infants(FWMD 0.78 studies, 583 infants), before 34 weeks(RR0.58,95%CI0.47to days, 95%CI-2.43 to 3.99 days, three studies, 321 infants 0.72, five studies, 1177 infants) and before 36 weeks(RR 0.54 95%CI 0.41 to 0.72, three studies, 922 infants), but not in those 2. Subgroup analysis born before 28 weeks(rRo.79, 95%CI 0.53 to 1. 18, four studies, antenatal corticosteroids versus placebo or no treatment(by 102 infants), at a gestation of at least 34 weeks(RR 0.66,95% ingle or multiple pregnancy) CI 0.38 to 1.16, five studies, 1261 infants)and at a gestation of Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth( Review) Copyright @2006 The Cochrane Collaboration. Published by John wiley& Sons, Ltdcontrols were seen for childhood weight (FWMD 0.30 kg, 95% CI -0.39 to 1.00 kg, two studies, 333 children), height (FWMD 1.02 cm, 95% CI -0.26 to 2.29 cm, two studies, 334 children), head circumference (FWMD 0.27 cm, 95% CI -0.08 to 0.63 cm, two studies, 328 children), lung function (vital capacity FWMD -1.68 % predicted, 95% CI -5.12 to 1.75 % predicted, two stud￾ies, 150 children), systolic blood pressure (FWMD -1.60 mmHg, 95% CI -4.06 to 0.86 mmHg, one study, 223 children), visual impairment (RR 0.55, 95% CI 0.24 to 1.23, two studies, 166 children), hearing impairment (RR 0.64, 95% CI 0.04 to 9.87, two studies, 166 children), behavioural/learning difficulties (RR 0.86, 95% CI 0.35 to 2.09, one study, 90 children) or intellectual impairment (RR 0.86, 95% CI 0.44 to 1.69, three studies, 778 children). For the child as adult One study (Liggins 1972b) showed increased insulin release 30 minutes following a fasting 75 g oral glucose tolerance test (FWMD 0.16 log insulin units, 95% CI 0.04 to 0.28 log insulin units, one study, 412 adults) in 30 year olds who had been ex￾posed to antenatal corticosteroid. However, thestudy reported no difference between those exposed to antenatal corticosteroids and controls in the prevalence of diabetes. No statistically significant differences between thoseexposed to antenatal corticosteroidsand controls were seen for weight (FWMD 0.80 kg, 95% CI -2.02 to 3.62 kg, two studies, 538 adults), height (FWMD 0.91 cm, 95% CI -0.28 to 2.10 cm, two studies, 537 adults), head circumference (FWMD 0.03 cm, 95% CI -0.33 to 0.38 cm, two studies, 537 adults), skinfold thickness (triceps FWMD -0.02 log units, 95% CI -0.11 to 0.07 log units, one study, 456 adults), systolic blood pressure (FWMD -0.87 mmHg, 95% CI -2.81 to 1.07 mmHg, two studies, 545 adults), HPA axis function (Cortisol FWMD 0.06 log units, 95% CI -0.02 to 0.14 log units, one study, 444 adults),cholesterol (FWMD -0.11 mmol/L, 95% CI-0.28 to 0.06 mmol/L, one study, 445 adults), age at puberty (FWMD for fe￾males 0 years, 95% CI -0.94 to 0.94 years, one study, 38 adults), educationalattainment(RR0.94, 95% CI 0.80 to 1.10, onestudy, 534 adults), visual impairment (RR 0.91, 95% CI 0.53 to 1.55, one study, 192 adults), hearing impairment (RR 0.24, 95% CI 0.03 to 2.03, one study, 192 adults) or intellectual impairment (RR 0.24, 95% CI 0.01 to 4.95, two studies, 273 adults). For the health services No statistically significant differences between groups treated with antenatal corticosteroidsand controls wereseen for length ofante￾natal hospitalisation forwomen (FWMD 0.50 days, 95% CI-1.40 to 2.40 days, onestudy, 218 women), postnatal hospitalisation for women (FWMD 0.00 days, 95% CI -1.72 to 1.72 days, onestudy, 218 women) or neonatal hospitalisation for infants (FWMD 0.78 days, 95% CI -2.43 to 3.99 days, three studies, 321 infants). 2. Subgroup analysis Antenatal corticosteroids versus placebo or no treatment (by single or multiple pregnancy) Data wereavailable for several of the primary outcomes that relate to the motherand fetus or neonatefor pregnanciescomplicated by multiple birth. However most of these were from just two studies (Collaborative 1981; Liggins 1972b). No statistically significant differences between groups treated with antenatal corticosteroids (in women with multiple pregnancies) and controls were seen for chorioamnionitis (RR 0.48, 95% CI 0.04 to 4.49, one study, 74 women), fetal death (RR 0.53, 95% CI 0.20 to 1.40, two studies, 252 infants), neonatal death (RR 0.79, 95% CI 0.39 to 1.61, two studies, 236 infants), RDS (RR 0.85, 95% CI 0.60 to 1.20, four studies, 320 infants), cerebroventricular haemorrhage (RR 0.39, 95% CI 0.07 to 2.06, onestudy, 137 infants) or birthweight (FWMD 82.36 grams, 95% CI -146.23 to 310.95 grams, one study, 150 infants), although the RRs were similar to those in the overall analysis, though small numbers meant the confidence intervals were wide and crossed one. Antenatal corticosteroids versus placebo or no treatment (by gestational age at delivery) Data were available by gestational age at delivery for several of the primary outcomes that relate to the mother and fetus or neonate. Combined fetal and neonatal death was significantly reduced in corticosteroid treated infants born before 32 weeks (RR 0.71, 95% CI 0.57 to 0.88, three studies, 453 infants), before 34 weeks (RR 0.73, 95% CI 0.58 to 0.91, one study, 598 infants) and before 36 weeks (RR 0.75, 95% CI 0.61 to 0.94, two studies, 969 infants), but not in those born before 28 weeks (RR 0.81, 95% CI 0.65 to 1.01, two studies, 129 infants), before 30 weeks (RR 0.86, 95% CI 0.70 to 1.05, one study, 201 infants) and at a gestation of at least 34 weeks (RR 1.13, 95% CI 0.66 to 1.96, one study, 770 infants). In infants born at a gestation of at least 36 weeks, there was a non-significant trend towards an increase in combined fetal and neonatal death (RR 3.25, 95% CI 0.99 to 10.66, two studies, 498 infants). Neonatal death was significantly reduced in corticosteroid treated infants born before 32 weeks (RR 0.59, 95% CI 0.43 to 0.80, three studies, 378 infants), before 34 weeks (RR 0.69, 95% CI 0.52 to 0.92, two studies, 715 infants) and before 36 weeks (RR 0.68, 95% CI 0.50 to 0.92, two studies, 869 infants), but not in those born before 28 weeks (RR 0.79, 95% CI 0.56 to 1.12, two studies, 89 infants), before 30 weeks (RR 0.82, 95% CI 0.60 to 1.11, one study, 150 infants), at a gestation of at least 34 weeks (RR 1.58, 95% CI 0.71 to 3.50, two studies, 808 infants), and at a gestation of at least 36 weeks (RR 2.62, 95% CI 0.77 to 8.96, three studies, 514 infants). RDS was significantly reduced in corticosteroid treated infants born before 30weeks(RR 0.67, 95% CI 0.52 to 0.87, fourstudies, 218 infants), before 32 weeks (RR 0.56, 95% CI 0.45 to 0.71, six studies, 583 infants), before 34 weeks (RR 0.58, 95% CI 0.47 to 0.72, five studies, 1177 infants) and before 36 weeks (RR 0.54, 95% CI 0.41 to 0.72, three studies, 922 infants), but not in those born before 28weeks(RR 0.79, 95% CI 0.53 to 1.18, fourstudies, 102 infants), at a gestation of at least 34 weeks (RR 0.66, 95% CI 0.38 to 1.16, five studies, 1261 infants) and at a gestation of Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth (Review) 9 Copyright © 2006 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd 第 103 页