Data were not available for all primary outcomes from all included delivered. No statistically significant differences between those treated with antenatal corticosteroids and controls were seen for For the mother fever after trial entry requiring the use of antibiotics(RR 1.11 No statistically significant differences were seen for maternal death 95%CI 0.74 to 1.67, four studies, 481 women), intrapartum fever requiring the use of antibiotics(RR 0.60, 95% CI 0.15 to (relative risk(RR)0.98, 95% confidence interval(CD)0.06 to 2.49, two studies, 319 women), postnatal fever(RR.92,95% 15.50, three studies, 365 women), chorioamnionitis(RR 0.91, CI 0.64 to 1.33, five studies, 1323 women), admission to adult 95%CI0.70 to 1.18, 12 studies, 2485 women) or puerperal sepsis (RR 1.35, 95%CI 0.93 to 1.95, eight studies, 1003 women) intensive care unit(RR 0.74, 95%CI 0.26 to 2.05, two studies 319 women), hyper RR1.00,95%CI0.36to2.76,on For the fetus or neonate tudy, 220 women)or reported side-effects of treatment(no events Treatment with antenatal corticosteroids was associated with an reported in 101 women) overall reduction in combined fetal and neonatal death(RR 0.77, For the fetus or neonate 95%CI 0.67 to 0.89, 13 studies, 3627 infants). This reduction is nly due to a reduction in neonatal death(Rr 0.69, 95% Treatment with antenatal corticosteroids was associated with a re. duction in the incidence of necrotising enterocolitis(RR 0.46, 0.98,95%CI 0.73 to 1.30, 13 studies, 3627 infants). Treatment antenatal corticosteroids was also associated with fewer infant reduction in respiratory distress syndrome(RDS)(RR 0.66, 95% having systemic infection in the first 48 hours after birth(RR 0.56, CI0.59 to 0.73, 21 studies, 4038 infants), moderate rds 95%CI 0.38 to 0.85, five studies, 1319 infants)and a trend (RR 0.55, 95%CI 0.43 to 0.71, six studies, 1686 infants),cere- wards fewer infants having proven infection while in the neonatal broventricular haemorrhage(RR 0.54, 95%CI 0 43 to 0.69, 13 ntensive care unit(NICU)(RR 0.83, 95% CI 0.66 to 1.03, (RR O 28, 95% CI 0.16 to 0. 50, five studies, 572 infants). The ticosteroids was associated with less need for neonatal respiratory reduction in intraventricular haemorrhage was seen both in cases support; with a reduction in the need for mechanical ventilation/ diagnosed at (RR O48,95%CI 0.29 to 0.79, five studies, contnuous positive airways pressure(CPAP)(RR 0.69, 95%CI 1846 infants)and by ultrasound(RR 0.58, 95%CI 0.44 to 0.77, 0.53 to 0.90, four studies, 569 infants), less time requiring me. seven studies, 889 infants). No statistically significant differences chanical ventilation/CPAP(FWMD-3. 47 days, 95% CI-5. were seen for chronic lung disease(RR0.86, 95%CI 0.61 to 1.22 gen supplementation(FWMD-2.86 days,95%C1-5.51 to-0.21 six studies, 818 infants)or birthweight(fixed weighted mean dif- need for surfactant(RR 0.72, 95%CI 0.51 to 1.03, three studies ference(FWMD)-17.48 grams, 95%CI-6208 to 27. 13 grams, 456 infants). No statistically significant differences between those 1l studies, 3586 infants) exposed to antenatal corticosteroids and controls were seen for air For the child leak syndrome(rR0.69, 95%CI0. 19 to 2. 47, one study, 138 in- No statistically significant differences were seen for death in child- fants), Apgar scores less than seven at five minutes(RRo.85,95% hood(rRO.68, 95%CI 0.36 to 1.27, four studies, 1010 children) CI 0.70 to 1.03, six studies, 1712 infants), interval between trial or neurodevelopmental delay(rro.64, 95%CI 0.14 to 2.98, one entry and delivery(FWMD 0 23 days, 95%CI-1.86 to 2. 32 days, dy, 82 children three studies, 1513 infants), incidence of small-for-gestational age infants(RR0.96, 95%CI 0.63 to 1.44, three studies, 378 infants) hood(RR 1.00, 95%CI 0.56 to 1.81, one study, 988 adults). No data were available for neurodevelopmental delay in adulthood. Overall, treatment with antenatal corticosteroids was associated with fewer infants being admitted into a NICU (RR 0.80,95% Secondary outcomes Cl 0.65 to 0.99, two studies, 277 infants) Data were available for several of the secondary outcomes that For the child relate to the mother. fetus or neonate, child, adult and health Treatment with corticosteroids was associated with less develop- mental delay in childhood(RR 0.49, 95%CI 0. 24 to 1.00,two For the mother studies,518 children, age at follow up three years in one study One study (Amorim 1999) reported that women in the corti- and unknown in one study) and a trend towards fewer children costeroid arm were more likely to have glucose intolerance than having cerebral palsy(Rr 0.60, 95%CI 0.34 to 1.03, five stud- the control arm(RR 2.71, 95%CI 1.14 to 6.46, one study, ies, 904 children, age at follow up two to six years in four stud- 123 women). This study used a treatment regimen that included ies, and unknown in one study). No statistically significant dif- kly repeat doses of corticosteroids if the infant remained un- ferences between those exposed to antenatal corticosteroids and 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, LtdData were notavailableforall primary outcomes from all included studies. For the mother No statistically significant differences wereseen for maternal death (relative risk (RR) 0.98, 95% confidence interval (CI) 0.06 to 15.50, three studies, 365 women), chorioamnionitis (RR 0.91, 95% CI 0.70 to 1.18, 12 studies, 2485 women) or puerperal sepsis (RR 1.35, 95% CI 0.93 to 1.95, eight studies, 1003 women). For the fetus or neonate Treatment with antenatal corticosteroids was associated with an overall reduction in combined fetal and neonatal death (RR 0.77, 95% CI 0.67 to 0.89, 13 studies, 3627 infants). This reduction is mainly due to a reduction in neonatal death (RR 0.69, 95% CI 0.58 to 0.81, 18 studies, 3956 infants), rather than fetal death (RR 0.98, 95% CI 0.73 to 1.30, 13 studies, 3627 infants). Treatment with antenatal corticosteroids was also associated with an overall reduction in respiratory distress syndrome (RDS) (RR 0.66, 95% CI 0.59 to 0.73, 21 studies, 4038 infants), moderateto severeRDS (RR 0.55, 95% CI 0.43 to 0.71, six studies, 1686 infants), cere￾broventricular haemorrhage (RR 0.54, 95% CI 0.43 to 0.69, 13 studies, 2872 infants) and severe cerebroventricular haemorrhage (RR 0.28, 95% CI 0.16 to 0.50, five studies, 572 infants). The reduction in intraventricular haemorrhage was seen both in cases diagnosed at autopsy (RR 0.48, 95% CI 0.29 to 0.79, five studies, 1846 infants) and by ultrasound (RR 0.58, 95% CI 0.44 to 0.77, seven studies, 889 infants). No statistically significant differences between those exposed to antenatal corticosteroids and controls wereseen forchroniclung disease(RR 0.86, 95% CI 0.61 to 1.22, six studies, 818 infants) or birthweight (fixed weighted mean dif￾ference (FWMD) -17.48 grams, 95% CI -62.08 to 27.13 grams, 11 studies, 3586 infants). For the child No statistically significant differences wereseen for death in child￾hood (RR 0.68, 95% CI 0.36 to 1.27, four studies, 1010 children) or neurodevelopmental delay (RR 0.64, 95% CI 0.14 to 2.98, one study, 82 children). For the child as adult No statistically significant difference was seen for death into adult￾hood (RR 1.00, 95% CI 0.56 to 1.81, one study, 988 adults). No data were available for neurodevelopmental delay in adulthood. Secondary outcomes Data were available for several of the secondary outcomes that relate to the mother, fetus or neonate, child, adult and health services. For the mother One study (Amorim 1999) reported that women in the corti￾costeroid arm were more likely to have glucose intolerance than in the control arm (RR 2.71, 95% CI 1.14 to 6.46, one study, 123 women). This study used a treatment regimen that included weekly repeat doses of corticosteroids if the infant remained un￾delivered. No statistically significant differences between those treated with antenatal corticosteroids and controls were seen for fever after trial entry requiring the use of antibiotics (RR 1.11, 95% CI 0.74 to 1.67, four studies, 481 women), intrapartum fever requiring the use of antibiotics (RR 0.60, 95% CI 0.15 to 2.49, two studies, 319 women), postnatal fever (RR 0.92, 95% CI 0.64 to 1.33, five studies, 1323 women), admission to adult intensive care unit (RR 0.74, 95% CI 0.26 to 2.05, two studies, 319 women), hypertension (RR 1.00, 95% CI 0.36 to 2.76, one study, 220 women) or reported side-effects of treatment (no events reported in 101 women). For the fetus or neonate Treatment with antenatal corticosteroids was associated with a re￾duction in the incidence of necrotising enterocolitis (RR 0.46, 95% CI 0.29 to 0.74, eight studies, 1675 infants). Treatment with antenatal corticosteroids was also associated with fewer infants having systemicinfection in the first 48 hoursafter birth (RR 0.56, 95% CI 0.38 to 0.85, five studies, 1319 infants) and a trend to￾wards fewer infants having proven infection while in the neonatal intensive care unit (NICU) (RR 0.83, 95% CI 0.66 to 1.03, 11 studies, 2607 infants). Furthermore, treatment with antenatalcor￾ticosteroids was associated with less need for neonatal respiratory support; with a reduction in the need for mechanical ventilation/ continuous positive airways pressure (CPAP) (RR 0.69, 95% CI 0.53 to 0.90, four studies, 569 infants), less time requiring me￾chanical ventilation/CPAP (FWMD -3.47 days, 95% CI -5.08 to -1.86 days, two studies, 198 infants) less time requiring oxy￾gen supplementation (FWMD -2.86 days, 95% CI -5.51 to -0.21 days, one study, 73 infants) and a trend towards a reduction in the need for surfactant (RR 0.72, 95% CI 0.51 to 1.03, three studies, 456 infants). No statistically significant differences between those exposed to antenatal corticosteroids and controls were seen for air leak syndrome(RR 0.69, 95% CI 0.19 to 2.47, one study, 138 in￾fants), Apgar scores less than seven at five minutes (RR 0.85, 95% CI 0.70 to 1.03, six studies, 1712 infants), interval between trial entry and delivery (FWMD 0.23 days, 95% CI -1.86 to 2.32 days, three studies, 1513 infants), incidence of small-for-gestational age infants (RR 0.96, 95% CI 0.63 to 1.44, threestudies, 378 infants) or hypothalamo-pituitary-adrenal (HPA) axis function (cortisol FWMD 3.94, 95% CI -3.12 to 11.00 days, onestudy, 27 infants). Overall, treatment with antenatal corticosteroids was associated with fewer infants being admitted into a NICU (RR 0.80, 95% CI 0.65 to 0.99, two studies, 277 infants). For the child Treatment with corticosteroids was associated with less develop￾mental delay in childhood (RR 0.49, 95% CI 0.24 to 1.00, two studies, 518 children, age at follow up three years in one study and unknown in one study) and a trend towards fewer children having cerebral palsy (RR 0.60, 95% CI 0.34 to 1.03, five stud￾ies, 904 children, age at follow up two to six years in four stud￾ies, and unknown in one study). No statistically significant dif￾ferences between those exposed to antenatal corticosteroids and Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth (Review) 8 Copyright © 2006 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd 第 102 页