We included eight trials randomising 232 preterm infants in this review . Inhalation corticosteroids did not reduce the separate or combined outcomes of death or BPD. The meta-analyses of the studies showed a reduced risk in favor of inhalation steroids regarding failure to extubate at seven days (typical RR (TRR) , 95% CI to ; 5 studies, 79 infants) and at the latest reported time point after treatment onset (TRR , 95% CI to ; 6 studies, 90 infants). However, both analyses showed increased statistical heterogeneity (I 2 statistic 73% and 86%, respectively). Furthermore, inhalation steroids did not impact total duration of mechanical ventilation or oxygen dependency. There was a trend toward a reduction in the use of systemic corticosteroids in infants receiving inhalation corticosteroids (TRR , 95% CI to ; 4 studies, 74 infants; very low-quality evidence). There was a paucity of data on short- and long-term adverse effects . Our results should be interpreted with caution because the total number of randomised participants is relatively small, and most trials differed considerably in participant characteristics, inhalation therapy , and outcome definitions.

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