Antenatal corticosteroid therapy and late preterm infant morbidity and mortality

Serrano, I.M. Gázquez; Plana, A. Arroyos; Ortiz, Morales; Perea, C. Herráiz; Bragado, A. Holgueras

doi:10.1016/j.anpede.2014.01.003

Cited by 12 publications

(10 citation statements)

References 33 publications

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“…This nding is consistent with the ndings of a previous study by Serrano et al in Spain. [10] In this prospective observational study, it was reported that betamethasone administration was signi cantly associated with a reduction in the level of respiratory distress syndrome among the parturient. [10] In this study, there was a 9-fold reduction in the level of transient tachypnea of the newborn among the neonates whose mothers had antenatal corticosteroid administered as against the controls.…”

Section: Resultsmentioning

confidence: 91%

“…[10] In this prospective observational study, it was reported that betamethasone administration was signi cantly associated with a reduction in the level of respiratory distress syndrome among the parturient. [10] In this study, there was a 9-fold reduction in the level of transient tachypnea of the newborn among the neonates whose mothers had antenatal corticosteroid administered as against the controls. This nding is similar to that reported by Gyam -Bannerman et al in the United States of America who reported approximately a 2-fold increase in the level of transient tachypnea of the newborn among the neonates of the parturients who were not given antenatal corticosteroid.…”

Section: Resultsmentioning

confidence: 91%

“…[1][2][3][4] Presently, there is no generally accepted consensus on the use of antenatal corticosteroid for the prevention of respiratory morbidity in babies born in the late preterm period. Studies done in Thailand, [8] Sweden, [9] Spain, [10] Turkey, [11] and the Antenatal late preterm study, [12] all support the use of antenatal corticosteroids in the prevention of morbidity and mortality associated with late preterm delivery, while those done in Brazil, [13] the USA, [14] India, [15] and the recently published WHO randomized control trial [16] did not show any bene t. One study even showed an increase in perinatal morbidity and mortality in those that had antenatal corticosteroid. [16] Presently, in Nigeria, where the burden of prematurity is high, no study has been done to evaluate the role of antenatal corticosteroid in late preterm delivery, there is therefore need for more studies on this subject.…”

Section: Introductionmentioning

confidence: 99%

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Does the Use of Antenatal Corticosteroids Reduce Respiratory Morbidity in Babies Born in Late Preterm Period?

Shittu

Rabiu

Ahmed³

et al. 2023

Preprint

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Objective The aim of this study is to determine the effectiveness of antenatal corticosteroid in reducing respiratory morbidity in babies born in the late preterm period. Materials and methods Two hundred and eighty-six pregnant women at risk of having a late preterm delivery were studied. One hundred and forty-three (143) served as the cases and were given 2 doses of 12mg intramuscular dexamethasone 12 hours apart, while 143 served as the controls and were given a similar quantity of placebo. The women were followed up prospectively and data were collected on the pregnant women and their newborns on a standardized form. The neonates were assessed for acute respiratory distress syndrome and transient tachypnea of the newborn based on clinical signs, symptoms, and chest x-ray results (when indicated). The primary outcome was the occurrence of neonatal respiratory morbidity. Results The primary outcome occurred in 5 out of 130 infants (3.8%) in the dexamethasone group and 31 out of 122 (25.4%) in the placebo group (P value = 0.000003). Birth asphyxia, neonatal intensive care admission and need for active resuscitation at birth also occurred significantly less frequently in the dexamethasone group (P value 0.004, 0.009, 0.014 respectively). There were no significant group differences in the incidence of neonatal sepsis, neonatal jaundice, hypoglycemia and feeding difficulties. Conclusion Administration of dexamethasone to women at risk for late preterm delivery significantly reduced the rate of neonatal respiratory complications neonatal intensive care unit and need for active resuscitation at birth. Trial Registration: PACTR (www.pactr.org) Registration Number: PACTR202304579281358. The study was retrospectively registered on April 19, 2023.

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Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does the Use of Antenatal Corticosteroids Reduce Respiratory Morbidity in Babies Born in Late Preterm Period?

Shittu

Rabiu

Ahmed³

et al. 2023

Preprint

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“…The same study suggests that corticosteroids therapy did not significantly decrease the need for CMV, CPAP or fluid therapy while the use of surfactants and oxygen therapy with NICU admission were remarkably reduced in the treated groups. 42 It has been elucidated that antenatal corticosteroid whether it is betamethasone or dexamethasone based do not impact the incidence of chronic lung disease as previously described. 22 In contrast, this work suggests a significant reduction in chronic lung disease among extreme and very preterm neonates.…”

Section: Discussionmentioning

confidence: 92%

A Comparative Study of the Respiratory Neonatal Outcomes Utilizing Dexamethasone Sodium Phosphate versus a Mixture of Betamethasone Dipropionate and Betamethasone Sodium Phosphate as an Antenatal Corticosteroid Therapy

Altal¹,

Sharie²,

Zu’bi³

et al. 2021

IJGM

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The aim of this study is to compare the respiratory neonatal outcomes utilizing antenatal dexamethasone sodium phosphate (DSP) versus a mixture of betamethasone dipropionate and betamethasone sodium phosphate (B-DP/SP) for preterm births. Patients and Methods: All neonatal intensive care unit (NICU) admissions for prematurity were retrospectively identified at our center in the period between September 2016 and September 2018. Pregnant women expected to give preterm birth and received steroid injections whether it is DSP or B-DP/SP were included in the study. Maternal and obstetrical data along with the corresponding respiratory neonatal outcomes were extracted and analyzed. The population was categorized according to the gestational age into extremely preterm (less than 28 weeks), very preterm (28 up to 32 weeks) and moderate or late preterm (32 up to 37 weeks) in which the repository outcomes were compared in each sub-group. Results: A total of 650 premature neonates were included in the analysis. B-DP/SP illustrated a significant reduction in the occurrence of respiratory distress syndrome (RDS) among moderate or late preterm neonates (P = 0.003) compared to DSP. In contrast, a nonsignificant difference was observed between B-DP/SP and DSP regarding apnea of prematurity and transient tachypnea of the newborn. The number of neonates developed chronic lung disease has been remarkably reduced when using DSP in extremely (P = 0.038) and very (P = 0.046) preterm neonates when compared to B-DP/SP. Conclusion:The dual acting B-DP/SP formulation could possess a significant potential in reducing RDS in moderate or late preterm neonates, while DSP groups exhibit a favorable result in the development of chronic lung disease in extreme and very preterm cohorts. Such findings emphasize the need of further clinical trials, pharmacokinetics, pharmacodynamics and cost effectiveness studies to evaluate the durability of these findings.

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“…Neonatal jaundice was significantly less frequent in the GC administration than in the placebo group 23,24 . Therefore, prenatal GC administration could be an effective preventive measure.…”

Section: Introductionmentioning

confidence: 88%

Prenatal glucocorticoid administration enhances bilirubin metabolic capacity and increases Ugt1a and Abcc2 gene expression via glucocorticoid receptor and PXR in rat fetal liver

Kobayashi

Takeba

Ohta

et al. 2022

J of Obstet and Gynaecol

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Aim: Jaundice is especially common in premature infant born before 35 weeks. Because the premature infant liver is not fully developed at birth it may be incomplete the bilirubin metabolism. The purpose was to evaluate the metabolism and the excretion of bilirubin in the premature infant rat liver following prenatal glucocorticoid (GC) administration. Methods: Dexamethasone (DEX) was administered subcutaneously to pregnant Wistar rats for two consecutive days on gestational days 17 and 19. The fetus were delivered by cesarean section in gestational days 19 and 21. The mRNA levels and protein levels of bilirubin-metabolic enzymes and transporters in the fetal liver tissues were analyzed using RT-PCR immunohistochemistry staining and ELISA, respectively. We evaluated that the effect of bilirubin-metabolic enzymes in the primary fetal rat hepatocytes treated with DEX after pretreated with glucocorticoid receptor (GR, Nr3c1) and Pxr (Nr1i2) siRNA. Results: Ugt1a1 and Bsep (Abcb11) mRNA levels were significantly increased in the fetuses by prenatal GC administration. The mRNA levels of nuclear transcription factors Nr1i2, Car (Nr1i3), and Rxrα (Nr2b1) were also significantly increased in the fetuses by prenatal GC administration. In addition, DEX increased Nr1i2, Ugt1a1, and Abcc2 (Mrp2) mRNA levels in the primary fetal hepatocytes. The Nr3c1 or Nr1i2 siRNAmediated knockdown suppressed the increases of Ugt1a1, and Abcc2 mRNA levels induced by DEX, indicating that DEX are mediated by GC receptor and PXR in primary fetal hepatocytes. Conclusions: These results suggest that prenatal GC administration increases bilirubin-metabolic ability, in the premature liver, which may prevent jaundice in neonates.

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Antenatal corticosteroid therapy and late preterm infant morbidity and mortality

Cited by 12 publications

References 33 publications

Does the Use of Antenatal Corticosteroids Reduce Respiratory Morbidity in Babies Born in Late Preterm Period?

Does the Use of Antenatal Corticosteroids Reduce Respiratory Morbidity in Babies Born in Late Preterm Period?

A Comparative Study of the Respiratory Neonatal Outcomes Utilizing Dexamethasone Sodium Phosphate versus a Mixture of Betamethasone Dipropionate and Betamethasone Sodium Phosphate as an Antenatal Corticosteroid Therapy

Prenatal glucocorticoid administration enhances bilirubin metabolic capacity and increases Ugt1a and Abcc2 gene expression via glucocorticoid receptor and PXR in rat fetal liver

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