Restricted to preterm gestational ages: 16 studies
Limitations due to confounding and selection bias were common concerns for the risk-of-bias assessments
Critical or higher risk-of-bias: 14 studies
Moderate or higher risk-of-bias: all studies
Antenatal corticosteroid administration in twin pregnancies was associated with lower odds of
aOR 0.59 (95% CI, 0.43 to 0.80)
5 studies | 20,312 neonates
aOR 0.70 (95% CI, 0.57 to 0.86)
7 studies | 20,628 neonates
Results for other outcomes were inconclusive
Antenatal corticosteroid administration in twin pregnancies at risk for prematurity is associated with a reduced odds of neonatal mortality and respiratory distress syndrome
Limitations include risk of confounding and lack of reporting regarding why specific confounders were selected
Cochrane update of randomized trials showed similar trends, but evidence was limited due to small sample size
The authors state
Pending evidence from randomized trials in late-preterm twins, findings from this review of nonrandomized studies may help provide evidence supporting the use of antenatal corticosteroids in twin pregnancies at risk of preterm delivery
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