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Administration of corticosteroid therapy for HELLP syndrome in pregnant women: evidences from seven randomized controlled trials

Authors :
Wei-Jing Sun
Jing Hu
Qing Zhang
Jin-Mei Shan
Source :
Hypertension in Pregnancy, Vol 42, Iss 1 (2023)
Publication Year :
2023
Publisher :
Taylor & Francis Group, 2023.

Abstract

ABSTRACTBackground HELLP syndrome, featuring hemolysis, elevated liver enzymes, and thrombocytopenia, is life-threatening disease of pregnancy that triggers comorbidities in both pregnant women and the fetus/newborn. This study provides an updated systematic review and meta-analysis of relevant studies to assess the therapeutic efficacy of corticosteroids in maternal and neonatal outcomes.Methods Randomized control trials (RCTs) regarding the use of corticosteroids in the HELLP population from three electronic databases, including Ovid MEDLINE, Ovid EMBASE, andCochrane Central Register of Controlled Trials, were searched from database inception to 23 March 202323 March 2023.Results A total of 485 patients treated with corticosteroids from 7 RCTs were included. Compared to placebo, corticosteroids therapy failed to significantly improve the maternal outcomes regard to maternal morbidity (RR = 1.36, 95%CI [0.45, 4.10]), eclampsia (RR = 1.16, 95%CI [0.76, 1.77]), acute renal failure (RR = 0.71, 95%CI [0.41, 1.22]), pulmonary edema (RR = 0.34, 95%CI [0.10, 1.15]) and oliguria (RR = 1.08, 95%CI [0.75, 1.54]). In addition, pooled data showed that it wasn’t significant differences between corticosteroids therapy and placebo regarding neonatal outcomes.Conclusions This study compared the efficacy of corticosteroids in patients with HELLP syndrome, revealing that corticosteroids did not provide any significant benefit in clinical outcomes for pregnant women and newborns with HELLP. The conclusions of this study must be verified by a larger sample of high-quality RCTs.

Details

Language :
English
ISSN :
10641955 and 15256065
Volume :
42
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Hypertension in Pregnancy
Publication Type :
Academic Journal
Accession number :
edsdoj.b4ba07f002614453a98a2a85a6271e85
Document Type :
article
Full Text :
https://doi.org/10.1080/10641955.2023.2276726