TOPLINE:

Budesonide combined with pulmonary surfactant was linked to a nearly one third reduction in the incidence of bronchopulmonary dysplasia (BPD) compared with pulmonary surfactant alone in premature infants, a recent meta-analysis showed.

METHODOLOGY:

• Researchers conducted a meta-analysis of 12 randomized controlled trials involving 2428 premature infants, comparing intratracheal budesonide plus pulmonary surfactant with pulmonary surfactant alone.
• Data were extracted from databases such as EMBASE, MEDLINE, Web of Science, and Cochrane Central.
• The primary outcome was the incidence of BPD in infants receiving combined therapy vs those receiving pulmonary surfactant alone.
• Secondary outcomes were in-hospital mortality, need for repeated surfactant use, duration of hospital stay, and pulmonary hemorrhage incidence.

TAKEAWAY:

• Combined budesonide-surfactant therapy significantly reduced the risk for BPD (relative risk [RR], 0.66; P < .01).
• Treatment with combined therapy reduced in-hospital mortality (RR, 0.80), pulmonary hemorrhage incidence (RR, 0.61), and the need for repeated pulmonary surfactant administration (RR, 0.52; P ≤ .02 for all).

IN PRACTICE:

“Compared with the use of PS [pulmonary surfactant] alone, the combination of budesonide and PS may reduce the incidence of BPD, pulmonary hemorrhage, and in-hospital mortality in premature infants,” the authors of the study wrote.

SOURCE:

This study was led by Kaixu Wang , School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. It was published online on September 25, 2025, in Pediatric Pulmonology.

LIMITATIONS:

This study faced publication bias, which lowered the quality of evidence for primary outcomes. Most included studies were single-center trials with relatively small sample sizes. Additionally, diagnostic criteria for bronchopulmonary dysplasia were heterogeneous across the 12 included studies.

DISCLOSURES:

The authors reported receiving no specific funding for this study. Additionally, they declared having no conflicts of interest.

.This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.