Antenatal corticosteroids and incidence of neonatal respiratory distress after elective caesarean section in late preterm and term neonates

López, Aída de la Huerga; Alonso, Marta Sendarrubias; Jiménez, Ana; Pozo, Vanesa Matías del; Colomo, Cristina Álvarez; Moreno, María Begoña Prieto

doi:10.1016/j.anpede.2018.12.008

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Several studies have failed to demonstrate protective effects of steroids on respiratory morbidity of newborns delivered by CS at term (de la Huerga López et al 2019;Nooh et al 2018). An observational study done in Oman looking at RDS in neonates delivered at term by ELCS which included 650 patients showed 2.5% RDS prevalence in the overall study sample.…”

Section: Discussionmentioning

confidence: 99%

A retrospective cohort study on effects of antenatal steroids on respiratory morbidity for term elective caesarean sections in South Asian women

2022

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Background Respiratory distress (RD) is higher among newborns born by caesarean section (CS) compared to vaginal delivery. Royal College of Obstetricians and Gynaecologists recommend steroid administration for CS prior to 39 weeks. Effectiveness of steroids for neonatal RD at term is inconclusive. The racial differences are yet to be studied. Methods A single center retrospective cohort study was conducted in Colombo, Sri Lanka from December 2016 to February 2019. All mothers delivered by CS between 37+0 and 38+6 weeks were included. Mothers with severe maternal hypertension, fetal rhesus sensitization, intrauterine infection, multiple pregnancies and who received steroids at a prior gestation were excluded. Cohort was subdivided according to administration of intramuscular dexamethasone prior to CS. Primary outcomes measured were RD, admissions to neonatal intensive care unit (NICU) and special care baby unit (SCBU). Neonatal infections and maternal duration of hospital stay were recorded as secondary outcome measures. Results 560 patients were included. 23.2% of patients received antenatal corticosteroids. Incidence of RD, NICU admissions and SCBU admissions in the study cohort was 10%, 0.9%, and 2.7% respectively. Relative risk for developing RD in the steroid group compared to non-steroid group was 2.67 (95CI 1.64-4.35). 4.6% of the steroid group and 3.3% of the non-steroid group needed to be admitted to the NICU/SCBU (p=0.464). A significantly higher number of babies in the steroid group needed IV antibiotics. The average number of days the mothers were admitted to the hospital was 2.45 days (SD+/- 1.424) for steroid group and 1.4 days (SD+/- 0.856) for the non-steroid group (p < 0.001). Conclusions There is a significant increase in the respiratory morbidity in the dexamethasone administered south Asian mothers at term prior to CS. However, this effect has no clinical significance since the admissions to NICU and SCBU were not significantly different.

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Section: Discussionmentioning

confidence: 99%

A retrospective cohort study on effects of antenatal steroids on respiratory morbidity for term elective caesarean sections in South Asian women

2022

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“…The search identified 211 citations: 17 potentially eligible studies were evaluated, and 3 studies were included (online supplemental file 2). [38][39][40] These were two observational studies and a randomised controlled trial (RCT). All studies were conducted in high-income countries between 2010 and 2017, providing data on 205 pregnant women/neonates (online supplemental table 1).…”

Section: Associations Of Acs Therapy On Women Undergoing Elective Cs ...mentioning

confidence: 99%

Antenatal corticosteroids in specific groups at risk of preterm birth: a systematic review

Saito,

Nishimura,

Ota

et al. 2023

BMJ Open

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ObjectiveThis study aimed to synthesise available evidence on the efficacy of antenatal corticosteroid (ACS) therapy among women at risk of imminent preterm birth with pregestational/gestational diabetes, chorioamnionitis or fetal growth restriction (FGR), or planned caesarean section (CS) in the late preterm period.MethodsA systematic search of MEDLINE, EMBASE, CINAHL, Cochrane Library, Web of Science and Global Index Medicus was conducted for all comparative randomised or non-randomised interventional studies in the four subpopulations on 6 June 2021. Risk of Bias Assessment tool for Non-randomised Studies and the Cochrane Risk of Bias tool were used to assess the risk of bias. Grading of Recommendations Assessment, Development and Evaluations tool assessed the certainty of evidence.ResultsThirty-two studies involving 5018 pregnant women and 10 819 neonates were included. Data on women with diabetes were limited, and evidence on women undergoing planned CS was inconclusive. ACS use was associated with possibly reduced odds of neonatal death (pooled OR: 0.51; 95% CI: 0.31 to 0.85, low certainty), intraventricular haemorrhage (pooled OR: 0.41; 95% CI: 0.23 to 0.72, low certainty) and respiratory distress syndrome (pooled OR: 0.59; 95% CI: 0.45 to 0.77, low certainty) in women with chorioamnionitis. Among women with FGR, the rates of surfactant use (pooled OR: 0.38; 95% CI: 0.23 to 0.62, moderate certainty), mechanical ventilation (pooled OR: 0.42; 95% CI: 0.26 to 0.66, moderate certainty) and oxygen therapy (pooled OR: 0.48; 95% CI: 0.30 to 0.77, moderate certainty) were probably reduced; however, the rate of hypoglycaemia probably increased (pooled OR: 2.06; 95% CI: 1.27 to 3.32, moderate certainty).ConclusionsThere is a paucity of evidence on ACS for women who have diabetes. ACS therapy may have benefits in women with chorioamnionitis and is probably beneficial in FGR. There is limited direct trial evidence on ACS efficacy in women undergoing planned CS in the late preterm period, though the totality of evidence suggests it is probably beneficial.PROSPERO registration numberCRD42021267816.

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Antenatal corticosteroids and incidence of neonatal respiratory distress after elective caesarean section in late preterm and term neonates

Cited by 2 publications

References 12 publications

A retrospective cohort study on effects of antenatal steroids on respiratory morbidity for term elective caesarean sections in South Asian women

A retrospective cohort study on effects of antenatal steroids on respiratory morbidity for term elective caesarean sections in South Asian women

Antenatal corticosteroids in specific groups at risk of preterm birth: a systematic review

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