Morbimortalidad neonatal en un entorno de baja adherencia a corticosteroides prenatales

Pérez-Ramírez, René Oswaldo; Lona-Reyes, Juan Carlos; Ochoa-Meza, Cesar A.; Gómez-Ruiz, Larissa María; Ramos-Gutiérrez, Ruth Y.; Camarena-Pulido, E. Elizabeth; Gallegos-Marín, J. Antonio

doi:10.1016/j.anpedi.2018.11.011

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…All RNP who did not present RDS received antenatal corticosteroid therapy, the majority of patients with mild RDS with low life risk received a complete corticosteroid regimen, the development of moderate and severe RDS was associated with the lack of corticosteroid therapy, demonstrating an inversely proportional relationship between Antenatal corticosteroid therapy and the severity of respiratory distress. These results coincide with those of other researchers such as Pérez Ramírez et al, who in their study carried out in 2019 demonstrated that antenatal corticosteroid therapy reduces the risk of mortality in preterm newborns (11). Similarly, Escribano, Peña, López and Gómez in 2020, in their research, determined that there is a statistically significant correlation between the administration of antenatal corticosteroid therapy and the decrease in SDR in preterm newborns, translating into a decrease in neonatal morbidity and mortality.…”

Section: Discussionsupporting

confidence: 87%

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Antenatal Corticotherapy in the Prevention of Respiratory Distress Syndrome in Preterm Neonates

Jaramillo,

Moreno,

Vera

et al. 2024

JHS

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Introducction: Neonatal respiratory distress syndrome is a set of symptoms characterized by progressive respiratory distress that typically affects prematurely born newborns. It can manifest at birth or in the first hours of life and represents one of the main causes of respiratory failure and death in newborns. The underlying cause is a deficiency of pulmonary surfactant, a lipoprotein substance that coats the alveoli and prevents their collapse by reducing surface tension. Objective: Determine the effectiveness of the administration of antenatal corticosteroids in the prevention of respiratory distress syndrome in preterm newborns treated at the Matilde Hidalgo Specialized Hospital in Procel during the period 2021-2022. Methodology: A quantitative, non-experimental, crosssectional and retrospective study was carried out, with a correlational approach. The sample included 110 premature neonates. Results:The main risk factors related to the development of respiratory distress syndrome were male sex (53.6%), gestational age between 32 to 33 weeks (36.4%), maternal age between 20 to 34 years (55.5%), cesarean section delivery (58.2%) and gynecological maternal comorbidities (22.7%). The most used corticosteroid was dexamethasone (50.9%). All patients who did not develop respiratory distress syndrome received a corticosteroid therapy regimen and the administration of complete cycles of antenatal corticosteroids was related to the absence and/or lower degree of severity of the condition. There is an inversely proportional relationship between the use of prenatal corticosteroids and the severity of neonatal respiratory distress syndrome. Conclusions: The administration of antenatal corticosteroids was associated with a better respiratory outcome in premature neonates, preventing or reducing the severity of respiratory distress syndrome.

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Section: Discussionsupporting

confidence: 87%

“…According to a study carried out at the Matilde Hidalgo Specialized Hospital in Procel in 2019, around 132 preterm newborns (41.2%) were diagnosed with RDS, of which 47% (61 cases) were younger. at 34 weeks, revealing a significant incidence in this health institution (11).…”

Section: Respiratorymentioning

confidence: 79%

Antenatal Corticotherapy in the Prevention of Respiratory Distress Syndrome in Preterm Neonates

Jaramillo,

Moreno,

Vera

et al. 2024

JHS

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Antenatal corticosteroid therapy, delivery intervals and perinatal mortality in low-resource settings

Mwita,

Kamala,

Konje

et al. 2023

Journal of Tropical Pediatrics

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Background Uncertainty exists regarding the ideal interval between the administration of antenatal corticosteroids (ACS) and delivery. The study’s objective was to assess the risks of perinatal mortality and respiratory distress syndrome (RDS) among preterm neonates whose mothers gave birth within 48 h of the administration of ACS and those whose mothers gave birth between 48 h and 7 days. Methods The study design was a secondary analysis of data from an observational prospective chart review study that was carried out in Tanzania in 2020. Preterm infants born to mothers who got at least one dose of ACS between 28 and 34 weeks of pregnancy were included. Results A total of 346 preterm neonates (294 singletons and 52 twins) were exposed to ACS. Compared to infants born 48 h following the first dose of ACS, those exposed to the drug between 48 h and 7 days had significantly decreased rates of perinatal mortality and RDS. Multivariable analysis revealed that infants exposed ACS between 48 h and 7 days prior to delivery had lower risk of perinatal mortality (aRR 0.30, 95% CI 0.14–0.66) and RDS (aRR 0.27, 95% CI 0.14–0.52). Conclusion The first dose of ACS given between 48 h and 7 days before delivery was associated with a lower risk of perinatal mortality and RDS than when the first dose was given <48 h before delivery. To improve neonatal outcomes, healthcare providers should consider administering ACS to mothers at the appropriate time.

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Effectiveness of antenatal dexamethasone in reducing respiratory distress syndrome and mortality in preterm neonates: a nested case control study

et al. 2023

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Background Respiratory distress syndrome (RDS) is a significant cause of preterm neonatal morbidity and mortality globally. Measures like the use of antenatal corticosteroids (ACS) and immediate resuscitation of the newborn after birth are taken to abate preterm related complications. Most studies that evidenced the benefit of ACS were done in high resource settings. Therefore, this study was conducted to assess the effectiveness of ACS in reducing RDS and neonatal mortality in preterm neonates in resource-limited settings. Methods A three months prospective nested case–control study (1:2 unmatched) was conducted at Muhimbili National Hospital and Amana regional referral hospital in Dar es salaam, Tanzania. Neonates delivered at 28 to 34 gestational weeks were enrolled and followed up until discharge. Data analysis was done using the statistical package of social sciences version 23. Logistic regression analysis was used to determine the effect of ACS on the RDS and mortality in the cohort, controlling for important maternal and neonatal variables. All tests were considered statistically significant at p < 0.05. Results Out of 330 preterm neonates enrolled, 110 were cases and 220 were controls. The median gestational age at delivery was 30 weeks and 6 days (IQR 4.68) among cases and 33 weeks (IQR 3) among controls. One-minute APGAR score of < 7 (AOR: 3.11; 95% CI 1.54–6.30), and neonatal birth weight (AOR: 0.998; 95% CI 0.997–0.999) were significantly associated with RDS. No significant association was observed between ACS exposure and RDS occurrence (AOR: 1.65; 95% CI 0.86 – 3.15). The overall mortality rate was 9 per 1000 neonates. Neonatal mortality occurred only among cases whereby, a unit increase in gestational age was associated with a 30% reduction in neonatal mortality (Adjusted hazard ratio, AHR: 0.70, 95% CI: 0.5–0.92, p = 0.011). Conclusion Decrease in gestational age, one minute APGAR score of < 7 and decreasing birth weight were associated with RDS among preterm neonates. ACS was not associated with reduced RDS occurrence and neonatal mortality rates. Moreover, increase in gestation age was the only factor found to be protective against preterm neonatal mortality.

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Morbimortalidad neonatal en un entorno de baja adherencia a corticosteroides prenatales

Cited by 3 publications

References 19 publications

Antenatal Corticotherapy in the Prevention of Respiratory Distress Syndrome in Preterm Neonates

Antenatal Corticotherapy in the Prevention of Respiratory Distress Syndrome in Preterm Neonates

Antenatal corticosteroid therapy, delivery intervals and perinatal mortality in low-resource settings

Effectiveness of antenatal dexamethasone in reducing respiratory distress syndrome and mortality in preterm neonates: a nested case control study

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