Re: Antenatal corticosteroids for maturity of term or near term fetuses: systematic review and meta-analysis of randomized controlled trials
We thank Dr Chakraborty for the interest in our study.1 We completely agree that late preterm delivery and planned cesarean delivery >37 weeks are two distinct clinical situations. For this reason we analyzed data and forest plots separately (please see Table 3 and Table 4). We also agree about the different definition of outcomes in the original trials, which are clearly reported in Table 1. Nonetheless, the heterogeneity within the studies was low, the meta-analysis represented level-1 data and included appropriately powered, large-scale, well-design, high quality low risk of bias trials. The of heterogeneity and Hartung and Knapp results (which account for the uncertainty in estimating heterogeneity) all point to the efficacy of antenatal steroids for both late preterm birth (34-36 weeks) and for scheduled cesarean delivery at term (37-39 weeks), as studied so far.
REFERENCES
1) Saccone G, Berghella V. Antenatal corticosteroids for maturity of term or near term fetuses: systematic review and meta-analysis of randomized controlled trials. BMJ. 2016 Oct 12;355:i5044. doi: 10.1136/bmj.i5044.
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Re: Antenatal corticosteroids for maturity of term or near term fetuses: systematic review and meta-analysis of randomized controlled trials
We thank Dr Chakraborty for the interest in our study.1 We completely agree that late preterm delivery and planned cesarean delivery >37 weeks are two distinct clinical situations. For this reason we analyzed data and forest plots separately (please see Table 3 and Table 4). We also agree about the different definition of outcomes in the original trials, which are clearly reported in Table 1. Nonetheless, the heterogeneity within the studies was low, the meta-analysis represented level-1 data and included appropriately powered, large-scale, well-design, high quality low risk of bias trials. The of heterogeneity and Hartung and Knapp results (which account for the uncertainty in estimating heterogeneity) all point to the efficacy of antenatal steroids for both late preterm birth (34-36 weeks) and for scheduled cesarean delivery at term (37-39 weeks), as studied so far.
REFERENCES
1) Saccone G, Berghella V. Antenatal corticosteroids for maturity of term or near term fetuses: systematic review and meta-analysis of randomized controlled trials. BMJ. 2016 Oct 12;355:i5044. doi: 10.1136/bmj.i5044.
Competing interests: No competing interests