Effects of single and multiple courses of antenatal glucocorticoids in preterm newborns less than 30 weeks' gestation

Smith, Lynne M.; Qureshi, Naveen; Chao, Conrad R.

doi:10.1002/(sici)1520-6661(200003/04)9:2<131::aid-mfm9>3.0.co;2-m

Cited by 52 publications

(24 citation statements)

References 22 publications

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“…The vast majority of previous studies have shown the opposite relationship (i.e., antenatal glucocorticoids decrease the incidence of NEC). [19][20][21][22] To examine whether increased survival in the most at-risk neonates might have influenced our results, we re-evaluated our statistics using only neonates who survived to 28 days of life. The association between antenatal glucocorticoids and NEC persisted and the estimated odds ratio was unchanged.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Enterocolitis Among Neonates in the United States

et al. 2003

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BACKGROUND:Prior studies have identified individual risk factors that are associated with necrotizing enterocolitis (NEC); however, the small sample sizes of these previous studies have not allowed the analysis of potential interaction between multiple variables and NEC. Our purpose was to describe the incidence and risk factors for NEC in premature neonates admitted for intensive care. METHODS:We identified neonates as having NEC if they met accepted diagnostic criterion for necrotizing enterocolitis. Using a national database, we assessed the association between NEC and a battery of risk factors previously reported in peer-reviewed literature. RESULTS:There were 15,072 neonates that met inclusion criteria; 14,682 did not have NEC, while 390 (2.6%) met criterion for NEC. Multivariate analysis showed that low birth weight was the most important risk factor for NEC. Other factors that were associated with an increased risk of NEC were exposure to antenatal glucocorticoids, vaginal delivery, need for mechanical ventilator support, exposure to both glucocorticoids and indomethacin during the first week of life, absence of an umbilical arterial catheter, and low Apgar score at 5 minutes. Length of hospital stay and mortality were higher in neonates with NEC than in neonates without NEC. CONCLUSIONS:NEC remains an important cause of morbidity and mortality in prematurely born neonates. In contrast to previous studies, we found that exposure to antenatal glucocorticoids was associated with an increased risk for NEC independent of birth weight.

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Section: Discussionmentioning

confidence: 99%

Necrotizing Enterocolitis Among Neonates in the United States

et al. 2003

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“…The authors observed that those who had received one course of medication presented a lower incidence of NEC. 51 Other experiments, however, have not demonstrated the same results. Kamisuka et al, analyzing premature infants born at gestational ages of less than 35 weeks and with birth weights between 1,250 and 2,500 g, observed an incidence of NEC that was twice as frequent among the children whose mothers had received antenatal corticosteroid.…”

Section: Antenatal Corticoid Therapymentioning

confidence: 89%

Avanços em enterocolite necrosante

Oliveira¹,

Miyoshi²

2005

J. Pediatr. (Rio J.)

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Suggested citation: de Oliveira ND, Miyoshi MH. Advances in necrotizing enterocolitis. J Pediatr (Rio J). 2005;81(1 Suppl):S16-S22. AbstractObjective: To evaluate recently reported findings on necrotizing enterocolitis, paying particular attention to pathogenesis, management and preventative strategies.Data sources: The articles covered in this report consist of randomized and quasi-randomized trials, case control studies, meta-analyses and reviews published recently. Certain other articles were also included because of their utmost importance to the subject.Results: Necrotizing enterocolitis remains a major cause of morbidity and mortality in preterm infants. Those who are born with intra-uterine-growth retardation are at a several-fold increased risk. Possible pathophysiologic processes beginning in utero and continuing after birth are discussed in this review. Other factors involved in the process are related to the role of arginine and the production of intestinal nitric oxide and the action of epidermal growth factor in the regulation of cell regeneration. Perforated necrotizing enterocolitis is a complex surgical problem; definitive evidence-based guidelines for the best approach are yet to be determined. After surgery, although residual small bowel length and the presence of the ileo-cecal valve remain important predictors of duration of parenteral nutrition in infants, other factors, such as the early use of breast milk or amino acid-based formula, may also play a role in intestinal re-adaptation. Prevention strategies have centered on feeding practices and emerging experiments such as amino acid supplementation, are also discussed. Conclusion:Significant results in terms of mortality and morbidity will be achieved through better understanding of necrotizing enterocolitis pathogenesis and clinical and surgical management in addition to the employment of preventative strategies.J Pediatr (Rio J). 2005;81(1 Suppl):S16-S22: Necrotizing enterocolitis, prematurity, short bowel syndrome.

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“…It has been recently established the use of repeated GCs courses every 14 days for those who still not delivered after the first course. Studies on animal models and also on human showed no additional benefits from repeated courses compared with single GCs course (110)(111)(112) and even can be harmful (113)(114)(115)(116).…”

Section: Antenatal Synthetic Steroid (Dexamethasone and Betamethsone)mentioning

confidence: 99%

Glucocorticoids: Biochemical Group That Play Key Role in Fetal Programming of Adult Disease

Erhuma¹

2012

Glucocorticoids - New Recognition of Our Familiar Friend

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Effects of single and multiple courses of antenatal glucocorticoids in preterm newborns less than 30 weeks' gestation

Cited by 52 publications

References 22 publications

Necrotizing Enterocolitis Among Neonates in the United States

Necrotizing Enterocolitis Among Neonates in the United States

Avanços em enterocolite necrosante

Glucocorticoids: Biochemical Group That Play Key Role in Fetal Programming of Adult Disease

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