Evaluation of prenatal corticosteroid use in spontaneous preterm labor in the Brazilian Multicenter Study on Preterm Birth (<scp>EMIP</scp>)

Dias, Tábata Z.; Passini, Renato; Tedesco, Ricardo Porto; Lajos, Giuliane J.; Rehder, Patrícia Moretti; Nomura, Marcelo Luís; Costa, Maria Laura; Oliveira, Paulo; Sousa, Maria Helena de; Cecatti, José Guilherme

doi:10.1002/ijgo.12297

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…Around 65% of sPTB before 34 weeks and 30% of late sPTB used ACS. The EMIP study, a multicentre cross-sectional study in 20 referral maternities in Brazil, showed that ACS was used in 54.0% of sPTB before 34 weeks and in 14.0% of late sPTB 27 . In accordance with the evidence-based recommendation for using ACS between 34 and 36 weeks raised by ALPS study 28 in 2016 and by 2017 Cochrane Systematic review 23 , an increase in the use of ACS can be observed between both Brazilian studies, EMIP (2011-2012) and Preterm SAMBA (2015-2018).…”

Section: Discussionmentioning

confidence: 99%

Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women

Souza

Costa

Mayrink

et al. 2020

Sci Rep

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the preterm SAMBA study group* Preterm birth is the major contributor for neonatal and under-five years mortality rates and also accounts for a short-and long-term adverse consequences up to adulthood. Perinatal outcomes may vary according to lots of factors as preterm subtype, late prematurity, which account for the vast majority of cases, country and population characteristics. An under-recognition of the perinatal outcomes and its associated factors might have underpowered strategies to provide adequate care and prevent its occurrence. We aim to estimate the frequency of maternal and perinatal outcomes in women with different categories of preterm and term births, factors associated with poorer perinatal outcomes and related management interventions. A multicentre prospective cohort in five maternities in Brazil between 2015 and 2018. Nulliparous low-risk women with singletons were included. Comprehensive data were collected during three antenatal visits (at 19-21weeks, 27-29 weeks and 37-39 weeks). Maternal and perinatal outcomes were also collected according to maternal and neonatal medical records. Women who had spontaneous (sPTB) and provider-initiated (pi-PTB) preterm birth were compared to those who had term birth. Also, late preterm birth (after 34 weeks), and early term (37-38 weeks) were compared to full term birth (39-40 weeks). Bivariate analysis estimated risk ratios for maternal and adverse outcomes. Finally, a multivariate analysis was conducted to address factors independently associated with any adverse perinatal outcome (APO). In total, 1,165 women had outcome data available, from which 6.7% had sPTB, 4.0% had pi-PTB and 89.3% had a term birth. sptB and pi-ptb were associated with poorer perinatal outcomes, as well as late sptB, late pi-ptB and early term neonates. pi-PTB (RR adj 8.12, 95% CI [2.54-25.93], p-value 0.007), maternal weight gain between 20 and 27 weeks

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Section: Discussionmentioning

confidence: 99%

Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women

Souza

Costa

Mayrink

et al. 2020

Sci Rep

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“…These characteristics may explain the increased use of antenatal corticosteroids in this group. The use of corticosteroids was previously evaluated in EMIP ( 17 ) and the results showed better outcomes among those who received this intervention before 34 weeks of preterm labor. In hypertensive disorders in pregnancy, mostly preeclampsia, the fetuses are exposed to oxidative stress, chronic hypoxia, and malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Hypertensive disorders during pregnancy as a major cause of preterm birth and adverse perinatal outcomes: findings from a Brazilian National Survey

Guida,

Dias,

Lajos

et al. 2024

Einstein (São Paulo)

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“…12 Among the women with preterm birth with gestational age less than 34 weeks, almost three-fourths received a corticosteroid, which was higher than the finding of a Brazilian Multicenter Study on Preterm Birth. 22 Three-fourths of the women in our study received a corticosteroid with the same dose and route as recommended by the American College of Obstetricians and Gynecologists. 23 A low proportion of women received a tocolytic in our study because most of the preterm women had gestational age >34 weeks or other indications for inducing preterm birth.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of an Epidemiological Surveillance System for Preterm Birth and Low Birth Weight in Southern Thailand

Liabsuetrakul

Defever

Lawantrakul

et al. 2018

J Health Sci Med Res

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Objective: To assess the prevalence and management of preterm birth and low birth weight (LBW) infants, including the exploration of known risk factors for preterm birth and LBW, recorded in field testing of a web-based surveillance system of maternal-newborn health in southern Thailand.Material and Methods: The data of 2,459 women who delivered in six community hospitals and two referral hospitals in Songkhla province, southern Thailand were extracted from the field testing records of an experimental surveillance system. The incidences of preterm and LBW and their management with attributed factors to the specific problems and associated factors were analyzed by univariate analysis and multiple logistic regression.Results:The incidences of preterm birth and LBW were 5.6% and 9.8%, respectively. Maternal age, parity, preeclampsia, antenatal care visits, birth attendant and type of hospital were significantly associated with the incidence of preterm birth or LBW. Of women with preterm birth, 8.4% received a tocolytic and 25.3% received corticosteroids. Half of the women with preterm birth were investigated for infection. More than half of the LBW births were related to a preterm condition and most of the LBW infants were appropriately resuscitated, given appropriate hypothermia prevention and early feeding, and infection prevention measures applied. Approximately 25.0% of the preterm and LBW infants had adverse fetal outcomes. Well-known limited factors were found in few cases of preterm and LBW infants.Conclusion: The incidence of preterm and LBW births and their management can be monitored in a timely way from a web-based surveillance system.

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Evaluation of prenatal corticosteroid use in spontaneous preterm labor in the Brazilian Multicenter Study on Preterm Birth (EMIP)

Abstract: Preterm labor and late preterm delivery were associated with worse neonatal outcomes following prenatal corticosteroids. This could reflect a sub-optimal interval between administration and delivery.

Cited by 5 publications

References 26 publications

Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women

Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women

Hypertensive disorders during pregnancy as a major cause of preterm birth and adverse perinatal outcomes: findings from a Brazilian National Survey

Evaluation of an Epidemiological Surveillance System for Preterm Birth and Low Birth Weight in Southern Thailand

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