Introduction:The mechanical cervical preparation method using extra-amniotic saline injection (EASI) is widely used; however, the effect of glucocorticoids such as dexamethasone is still controversial. Therefore, this meta-analysis aimed to evaluate the effect of extra-amniotic dexamethasone injection on labor induction. Method:We searched PubMed, Web of Science, ScienceDirect, Cochrane CENTRAL, and Google Scholar up to August 1, 2024, and updated the search through September 2025. We used RoB 2 to assess risk of bias and GRADE to assess the quality of evidence. Meta-analyses were performed with RevMan software version 5.4. Result:Seven randomized clinical trials of varying quality were included in the systematic review. According to the meta-analysis, the intervention group with extraamniotic dexamethasone injection had a shorter time from induction to active phase of labor (MD = -1.94 hours, 95% CI: -3.21 to -0.67, p = 0.003) and to delivery (MD = -1.97 hours, 95% CI: -2.76 to -1.17, p < 0.00001) and it was more effective than the control group with normal saline. The control and intervention groups had no statistically significant difference in spontaneous vaginal delivery (RR = 0.98, 95% CI 0.89 to 1.09, p = 0.74) or cesarean section (RR = 0.99, 95% CI 0.64 to 1.53, P = 0.96). Conclusion: Labor management with extra-amniotic dexamethasone infusion seems effective because of its labor acceleration effects. However, larger multicenter trials are needed to support these findings with greater certainty.
Larki, M. (2026). Efficacy of Extra-Amniotic Dexamethasone Infusion for Labor Induction: A Systematic Review and Meta-Analysis with Evidence Grading. Journal of Midwifery and Reproductive Health, (), 1–12. https://doi.org/10.22038/jmrh.2025.83564.2506
MLA
Larki, M. "Efficacy of Extra-Amniotic Dexamethasone Infusion for Labor Induction: A Systematic Review and Meta-Analysis with Evidence Grading", Journal of Midwifery and Reproductive Health, , 2026, 1–12. doi: 10.22038/jmrh.2025.83564.2506
HARVARD
Larki, M. (2026). 'Efficacy of Extra-Amniotic Dexamethasone Infusion for Labor Induction: A Systematic Review and Meta-Analysis with Evidence Grading', Journal of Midwifery and Reproductive Health, (), pp. 1–12. doi: 10.22038/jmrh.2025.83564.2506
CHICAGO
Larki, M., "Efficacy of Extra-Amniotic Dexamethasone Infusion for Labor Induction: A Systematic Review and Meta-Analysis with Evidence Grading." Journal of Midwifery and Reproductive Health, (2026): 1–12, doi: 10.22038/jmrh.2025.83564.2506
VANCOUVER
Larki M. Efficacy of Extra-Amniotic Dexamethasone Infusion for Labor Induction: A Systematic Review and Meta-Analysis with Evidence Grading. JMRH. 2026;():1–12. doi: 10.22038/jmrh.2025.83564.2506
