Background: Steroids are a potential treatment for pulmonary inflammation in meconium aspiration syndrome (MAS).
Objective: To assess the efficacy and safety of steroids for the management of neonates with MAS.
Design: Systematic review and meta-analysis of randomized controlled trials (RCT).
Data sources and selection criteria: A systematic search of PubMed, Embase, Cochrane, and CINAHL was performed from database inception to May 2020 for trials assessing the efficacy of steroids (inhaled/systemic or both) in neonates with MAS. The primary outcome was in-hospital mortality, with secondary outcomes being length of hospital stay and duration of oxygen support.
Results: Nine RCTs (758 neonates) were included. Overall, steroids did not decrease in-hospital mortality (RR: 0.59; 95% CI 0.28 to 1.23; I2 = 0%; GRADE: low) nor had any effect on the secondary outcomes.
Conclusions: There is low quality of evidence that the administration of steroids is not associated with a reduction in mortality in infants with MAS. Further well-designed studies with low bias are needed to draw conclusions.