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

ABSTRACT

Background

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.

KEYWORDS:

• HELLP
• pregnant women
• eclampsia
• corticosteroids
• comorbidities

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributors

JMS designed the research; WJS, JH and QZ collected the data and verified the accuracy of the data. JMS and WJS verified the accuracy of the data; WJS and JH contributed to data interpretation; WJS and QZ performed the statistical analysis and visualization; JMS and WJS wrote the manuscript. The authors read, critically reviewed, and approved the final manuscript.

Data availability statement

All data generated or analyzed during this study are included in this published article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article