Evaluation of the effect of antenatal betamethasone on neonatal respiratory morbidities in late preterm deliveries (34–37 weeks)

Mirzamoradi, Masoumeh; Nejhad, Fatemeh Hasani; Jamali, Razyeh; Heidar, Zahra; Bakhtiyari, Mahmood

doi:10.1080/14767058.2018.1554051

Cited by 20 publications

(19 citation statements)

References 24 publications

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“…The type, dose and duration of ANC prophylaxis varied in these 7 RCTs (Dexamethasone: 4, Betamethasone: 3). Five studies provided data for the primary outcome of need for any respiratory support [ 10 , 20 – 22 , 25 ] whereas only 4 reported on hypoglycemia [ 10 , 20 , 21 , 25 ]. The ALPS study by Gyamfi-Bannerman provided data for all outcomes included in this review [ 10 ].…”

Section: Resultsmentioning

confidence: 99%

“…Need for any respiratory support : Five RCTs that included 3844 neonates (ANC: 1941, Control: 1903) reported this outcome [ 10 , 20 – 22 , 25 ]. Need for any respiratory support was significantly less in the ANC vs. control group neonates [ANC: 11% vs. Control: 16%].…”

Section: Resultsmentioning

confidence: 99%

“…Admission to NICU : Six studies that reported this outcome included 3944 neonates (ANC: 1991, Control: 1953) [ 10 , 20 – 22 , 24 , 25 ]. There was no difference in admission to NICU in the ANC vs. control group neonates (ANC: 32% vs. Control: 38%).…”

Section: Resultsmentioning

confidence: 99%

“…TTN : The incidence of TTN was reported in 5 RCTs including 3844 neonates (ANC: 1941, C: 1903) [ 10 , 20 – 22 , 25 ]. TTN was less in the ANC vs. control group (ANC: 10% vs. Control: 11.5 but was not statistically significant [RR = 0.90 (0.66–1.24) p = 0.53; Chi 2 = 7.57, I 2 = 47%; LOE: Low].…”

Section: Resultsmentioning

confidence: 99%

“…Need for mechanical ventilation : The data for this outcome was available from 4 studies that included 3650 neonates (ANC: 1845, Control: 1805) [ 10 , 20 – 22 ]. Need for mechanical ventilation was 21% in ANC vs. 27% in control group.…”

Section: Resultsmentioning

confidence: 99%

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Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries—A systematic review and meta-analysis of RCTs

Deshmukh

Patole

2021

PLoS ONE

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Background Administration of antenatal corticosteroids (ANC) for impending preterm delivery beyond 34 weeks of gestation continues to be a controversial issue despite various guidelines for obstetricians and gynaecologists. Objective To compare outcomes following exposure to ANC for infants born between 34–36+6 weeks’ gestation. Methods A systematic review of randomised controlled trials (RCT) reporting neonatal outcomes after ANC exposure between 34–36+6 weeks’ gestation using Cochrane methodology. Databases including PubMed, Embase, Emcare, Cochrane Central library and Google Scholar were searched in May 2020. Primary outcomes: (1) Need for respiratory support (Mechanical ventilation, CPAP, high flow) or oxygen (2) Hypoglycemia. Secondary outcomes included respiratory distress syndrome (RDS), transient tachypnoea of newborn (TTN), need for neonatal resuscitation at birth [only in the delivery room immediately after birth (not in neonatal intensive care unit (NICU)], admission to NICU, mortality and developmental follow up. Level of evidence (LOE) was summarised by GRADE guidelines. Main results Seven RCTs (N = 4144) with low to high risk of bias were included. Only one RCT was from high income countries, Meta-analysis (random-effects model) showed (1) reduced need for respiratory support [5 RCTs (N = 3844); RR = 0.68 (0.47–0.98), p = 0.04; I2 = 55%; LOE: Moderate] and (2) higher risk of neonatal hypoglycaemia [4 RCTs (N = 3604); RR = 1.61(1.38–1.87), p<0.00001; I2 = 0%; LOE: High] after ANC exposure. Neonates exposed to ANC had reduced need for resuscitation at birth. The incidence of RDS, TTN and surfactant therapy did not differ significantly. None of the included studies reported long-term developmental follow up. Conclusions Moderate quality evidence indicates that ANC exposure reduced need for respiratory support, and increased the risk of hypoglycaemia in late preterm neonates. Large definitive trials with adequate follow up for neurodevelopmental outcomes are required to assess benefits and risks of ANC in this population.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries—A systematic review and meta-analysis of RCTs

Deshmukh

Patole

2021

PLoS ONE

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Antenatal Corticosteroid Treatment During the Late-Preterm Period and Neonatal Outcomes for Twin Pregnancies

Zhu,

Zhao,

et al. 2023

JAMA Netw Open

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ImportanceAntenatal corticosteroid treatment of individuals with singletons at risk for delivery during the late-preterm period has been academically recommended. However, the evidence on the use of antenatal corticosteroid treatment for twins at risk for delivery during the late-preterm period is still lacking.ObjectiveTo evaluate whether antenatal corticosteroid treatment during the late-preterm period in twin pregnancies was associated with a lower risk of newborn morbidity.Design, Setting, and ParticipantsThis retrospective cohort study of twin pregnancies delivered from February 1, 2013, to September 30, 2020, in a university-affiliated hospital in China included 1974 individuals with twin pregnancies who were at risk for late preterm birth (34 weeks and 0 days to 36 weeks and 6 days of gestation). Data were analyzed from June 30 to July 13, 2023.ExposuresAntenatal corticosteroid treatment during the late-preterm period.Main Outcomes and MeasuresThe primary outcome measure was composite neonatal respiratory morbidity, defined as at least 1 of the following postnatal occurrences in at least 1 neonate of the twins: respiratory distress syndrome, mechanical ventilation, surfactant administration, transferred with respiratory complications, or neonatal death. Propensity score overlap weighting was used to analyze the association between antenatal corticosteroid treatment and the risk of neonatal outcomes.ResultsThe study population consisted of 1974 individuals with twin pregnancies, including 303 (15.3%; mean [SD] maternal age, 30.8 [4.2] years) who received antenatal corticosteroid treatment and 1671 (84.7%; mean [SD] maternal age, 31.2 [4.0] years) who did not receive antenatal corticosteroid treatment. The propensity score overlap weighting showed no significant differences between the antenatal corticosteroid treatment group and the no–antenatal corticosteroid treatment group in the risk of neonatal primary outcome (29 of 303 [9.6%] vs 41 of 1671 [2.5%]; weighted odds ratio, 1.27 [95% CI, 0.60-2.76]). None of the subgroup interaction tests were significant for the neonatal primary outcome in terms of gestational age at delivery, year of delivery, chorionicity, at least 1 infant small for gestational age, intertwin growth discordance, and infant sex, and neither was the sensitivity analysis of using propensity score matching and a different administration-to-birth interval and treating twin infants as individuals.Conclusions and RelevanceThis cohort study found insufficient evidence that antenatal corticosteroid treatment during the late-preterm period in twin pregnancies could be associated with a lower risk of newborn morbidity. This new finding can provide a reference for clinical practice.

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Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth

McGoldrick

Stewart

Parker

et al. 2020

Cochrane Database of Systematic Reviews

318

365

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Evaluation of the effect of antenatal betamethasone on neonatal respiratory morbidities in late preterm deliveries (34–37 weeks)

Cited by 20 publications

References 24 publications

Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries—A systematic review and meta-analysis of RCTs

Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries—A systematic review and meta-analysis of RCTs

Antenatal Corticosteroid Treatment During the Late-Preterm Period and Neonatal Outcomes for Twin Pregnancies

Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth

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