Do corticosteroids affect prenatal biophysical parameters? A systematic review and meta-analysis

Abstract

This systematic review and meta-analysis aimed to evaluate the effect of betamethasone and dexamethasone on biophysical profile (BPP) parameters. In addition, it was performed in 2017, using several databases such as PubMed/MEDLINE, Scopus, EMBASE, Cochrane library, ISI Web of science, Proquest, and Google scholar, along with Magiran SID and IranMedex. Eligible studies were selected by two reviewers and the outcomes of interest were extracted as well. Meta-analysis was done using the random effect model. Further, I-square statistic test was used for heterogeneity analysis and the presence of publication bias was also checked. At last, 12 studies were included and a random and fixed effect model was used for analysis. The pooled event rates were 4.5% (95% CI = 0.01-64.3, P = 0.1), 76.8% (% 95 CI = 33.5-95.6, P = 0.21), 71.8% (% 95 CI=38.8-91.1, P = 0.18), 70.9% (%95 CI=38.4-90.5, P = 0.20), and 92.3% (%95 CI=76.0-97.8, P<0.001) for the reduced amniotic fluid volume, baseline fetal heart rate reactivity, fetal breathing, fetal movement, and heart rate variability, respectively. In summary, a significant decrease was observed in heart rate variability following betamethasone and dexamethasone administration. However, further systematic reviews are necessary to differentiate steroid induced changes in the fetal BPP from those due to fetal compromise.