Maturation par bêtaméthasone au cours d'une grossesse de femme présentant un diabète compliqué: le mieux est-il l'ennemi du bien?

Barondiot, Catherine Rosset; Morel, Olivier; Vieux, Rachel; Séry, G.A.; Floriot, M.; Hascoët, J.-M.

doi:10.1016/j.arcped.2007.03.025

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…This mechanism may be disrupted in hyperinsulinemic preterm newborns exposed to ACT, and persistent neonatal hypoglycemia can lead to serious consequences [35,36]. Fortunately, maternal hyperglycemia induced by corticosteroids lasts only a few days [37]. On the other hand, a recent study by Carpenter et al found an increase in granulocytes and a decrease in lymphocytes in the umbilical cord blood of fetuses whose mothers had received betamethasone treatment during late preterm period [38].…”

Section: Discussionmentioning

confidence: 99%

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(Is there a place for) antenatal corticosteroid treatment after 34 weeks of gestation in twin pregnancies when late preterm delivery is inevitable

Dereli,

Yücel,

Topkara

et al. 2024

Preprint

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Background Twins are associated with an increased risk of premature birth, a major cause of neonatal morbidity and mortality. Antenatal corticosteroid treatment (ACT) is the main intervention to improve neonatal outcomes in unavoidable preterm births. Our aim was to investigate the association between neonatal outcome and ACT in twin pregnancies with late preterm birth, where the effects of corticosteroids have not been adequately studied. Methods Women with dichorionic-diamniotic twins who had a late preterm birth between 2017 and 2021 at a large referral hospital providing tertiary care and medical training were retrospectively analyzed. Women who met the inclusion criteria were divided into three groups: No ACT (n = 209), ACT < 34 weeks' gestation (n = 76) and ACT ≥ 34 weeks' gestation (n = 67). The groups were compared with regard to adverse neonatal complications. Primary outcome measures were composite respiratory and composite neonatal outcomes. Logistic regression analysis was used to determine additional potential predictors of neonatal outcome. Results Composite respiratory and composite neonatal outcomes which did not differ significantly between groups. Gestational age at birth, birthweight and ACT before 34 weeks' gestation were independent protective factors for composite respiratory outcome, composite neonatal outcome and admission to the neonatal intensive care unit. Female gender was an independent protective factor for both composite respiratory outcome and neonatal intensive care unit admission, while gestational age at birth and birthweight were independent protective factors for hypoglycemia. Conclusion ACT at or after 34 weeks' gestation did not improve neonatal outcomes in dichorionic-diamniotic twins born late preterm and was associated with a higher rate of neonatal hypoglycemia than those not treated with corticosteroids.

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Section: Discussionmentioning

confidence: 99%

“…The World Health Organization classi es preterm births as mild or late (34)(35)(36)(37), moderate (32)(33)(34), very (28-32 WG), and extreme (< 28 WG) preterm births [2]. Late preterm births account for 60% of all live twin births [3].…”

Section: Introductionmentioning

confidence: 99%

(Is there a place for) antenatal corticosteroid treatment after 34 weeks of gestation in twin pregnancies when late preterm delivery is inevitable

Dereli,

Yücel,

Topkara

et al. 2024

Preprint

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“…Increased hepatic gluconeogenesis along with decreased glucagon levels, and decreased peripheral glucose uptake are the main mechanisms for maternal hyperglycemia induced by ACT [35]. In contrast to the long-lasting beneficial effects of ACT on the preterm infant, the maternal hyperglycemia induced by corticosteroids lasts only a few days [36]. Therefore, this effect is often negligible in pregnant women with diabetes, especially with good glycemic control, and is not a barrier to ACT.…”

Section: Discussionmentioning

confidence: 99%

The use of late preterm antenatal corticosteroids in women with gestational diabetes : a puzzle worth solving

Özkan,

Dereli,

Kurt

et al. 2024

BMC Pregnancy Childbirth

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Background To investigate the association between late preterm antenatal corticosteroid treatment and outcome in late preterm neonates born to mothers with gestational diabetes mellitus, Methods All patients with gestational diabetes mellitus who had a late preterm delivery at Etlik Lady Zübeyde Hospital between 2017 and 2021 were included. Women who met the inclusion criteria and were not given antenatal corticosteroid treatment during current pregnancy before 34 0/7 weeks of gestation were divided into two groups according to whether or not they received late preterm antenatal corticosteroid treatment. The two groups were compared in terms of adverse neonatal complications. The main outcomes were composite respiratory outcome and composite neonatal outcome. Logistic regression analysis was used to determine additional potential predictors of neonatal outcome. Results This retrospective cohort study included a total of 400 participants with gestational diabetes mellitus who had a late preterm delivery within the study period. Of these women, 196 (49%) received late preterm antenatal corticosteroid treatment. Main outcomes showed no difference. Decreasing gestational age at birth was identified as an independent risk factor predicting both composite respiratory outcome and composite neonatal outcome in multivariate logistic regression analysis. Conclusions Antenatal corticosteroid treatment at or after 34 0/7 weeks of gestation in women with gestational diabetes mellitus who had a late preterm delivery was not associated with improvement in adverse neonatal outcomes. Decreasing gestational age at birth was the only independent risk factor predicting composite neonatal and composite respiratory outcomes.

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Current awareness: Pharmacoepidemiology and drug safety

2008

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 20 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Maturation par bêtaméthasone au cours d'une grossesse de femme présentant un diabète compliqué: le mieux est-il l'ennemi du bien?

Cited by 6 publications

References 12 publications

(Is there a place for) antenatal corticosteroid treatment after 34 weeks of gestation in twin pregnancies when late preterm delivery is inevitable

(Is there a place for) antenatal corticosteroid treatment after 34 weeks of gestation in twin pregnancies when late preterm delivery is inevitable

The use of late preterm antenatal corticosteroids in women with gestational diabetes : a puzzle worth solving

Current awareness: Pharmacoepidemiology and drug safety

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