Value of antenatal corticosteroid therapy in preterm birth

Spinillo, Arsenio; Capuzzo, Ezio; Ometto, Ana María Holland; Stronati, Mauro; Baltaro, Federica; Iasci, Angela

doi:10.1016/0378-3782(95)01638-j

Cited by 49 publications

(38 citation statements)

References 18 publications

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“…Secondly, there was a significant reduction in moderate to severe RDS by corticosteroids in all study groups (twins, high-order multiple pregnancy) and the twin group who received only one course of dexamethasone therapy. This is in agreement with Spinillo et al [13] and others [12,18] who demonstrated a significant reduction in the incidence of RDS in multiple pregnancies treated with corticosteroids. Conversely, in some reports, the current regimen of antenatal corticosteroids utilized in twin pregnancies was found to be ineffective in reducing the incidence or severity of RDS [19,20].…”

Section: Discussionsupporting

confidence: 82%

“…However, although Ardila et al [12] did not achieve a significant overall reduction in the risk factors by antenatal maternal administration of betamethasone in twin pregnancies at 24-34 weeks of gestation, there was a significant reduction in the incidence of RDS in the babies born between 28 and 32 weeks of gestation. Spinillo et al [13] demonstrated that an overall corticosteroidrelated reduction in the risk of RDS was more marked among twin than singleton infants, thus strongly supporting the routine use of steroids in multiple pregnancy.…”

Section: Dexamethasone Reduces Rds In Multifetal Gestationmentioning

confidence: 95%

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Effect of Repeated Doses of Dexamethasone on the Incidence and Severity of Respiratory Distress Syndrome in Multifetal Gestation between 24 and 34 Weeks

Al‐Yatama¹,

Essa

Omu³

et al. 2001

Gynecol Obstet Invest

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The objective of the study was to evaluate the effects of antenatal corticosteroid therapy in multiple pregnancy on the incidence and severity of respiratory distress syndrome (RDS). Twenty-two women with twin, 12 with triplet and 2 with quadruplet pregnancies and an emergency group of 20 mothers with twin pregnancies, who only had one course of dexamethasone, were compared with controls. Corticosteroid therapy was associated with a reduction in moderate to severe RDS in all groups (twins p < 0.01, triplets and quadruplets p < 0.008) and the emergency group with dexamethasone therapy (p < 0.036) when compared to their individual controls. Dexamethasone reduced the duration of stay in the neonatal intensive care unit of the emergency twin group (p < 0.01). Neonatal birth weights were significantly less in all groups treated with repeated doses in comparison to the controls.

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Section: Discussionsupporting

confidence: 82%

Section: Dexamethasone Reduces Rds In Multifetal Gestationmentioning

confidence: 95%

Effect of Repeated Doses of Dexamethasone on the Incidence and Severity of Respiratory Distress Syndrome in Multifetal Gestation between 24 and 34 Weeks

Al‐Yatama¹,

Essa

Omu³

et al. 2001

Gynecol Obstet Invest

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“…7 More recently, increased use of antenatal steroids and the availability of surfactant therapy are considered important advances contributing to improved neonatal outcome presumably by decreasing the incidence and severity of conditions associated with preterm births such as respiratory distress syndrome (RDS). [8][9][10][11][12][13] Since males are at higher risk of prematurity and prematurity-related conditions such as RDS, 14,15 it is possible that these advances in therapy could differentially benefit male infants, and as a result, alter the sex difference in mortality.…”

Section: Introductionmentioning

confidence: 99%

Narrowing of Sex Differences in Infant Mortality in Massachusetts

et al. 2004

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“…[72][73][74][75][76][77][78][79][80] While male fetuses appear to adapt their placental function to maintain continued growth, female fetuses exhibit reduced growth in what is hypothesized to be an attempt to survive any further potential maternal insults. 80,81 Consistent with this, we found that male fetal weight was unaffected by early DEX treatment.…”

Section: Braun Et Al 55mentioning

confidence: 99%

Early Dexamethasone Treatment Induces Placental Apoptosis in Sheep

et al. 2015

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Glucocorticoid treatment given in late pregnancy in sheep resulted in altered placental development and function. An imbalance of placental survival and apoptotic factors resulting in an increased rate of apoptosis may be involved. We have now investigated the effects of dexamethasone (DEX) in early pregnancy on binucleate cells (BNCs), placental apoptosis, and fetal sex as a determinant of these responses. Pregnant ewes carrying singleton fetuses (n ¼ 105) were randomized to control (n ¼ 56, 2 mL saline/ewe) or DEX treatment (n ¼ 49, intramuscular injections of 0.14 mg/kg ewe weight per 12 hours over 48 hours) at 40 to 41 days of gestation (dG). Placentomes were collected at 50, 100, 125, and 140 dG. At 100 dG, DEX in females reduced BNC numbers, placental antiapoptotic (proliferating cell nuclear antigen), and increased proapoptotic factors (Bax, p53), associated with a temporarily decrease in fetal growth. At 125 dG, BNC numbers and apoptotic markers were restored to normal. In males, ovine placental lactogen-protein levels after DEX were increased at 50 dG, but at 100 and 140 dG significantly decreased compared to controls. In contrast to females, these changes were independent of altered BNC numbers or apoptotic markers. Early DEX was associated with sex-specific, transient alterations in BNC numbers, which may contribute to changes in placental and fetal development. Furthermore, in females, altered placental apoptosis markers may be involved.

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Value of antenatal corticosteroid therapy in preterm birth

Cited by 49 publications

References 18 publications

Effect of Repeated Doses of Dexamethasone on the Incidence and Severity of Respiratory Distress Syndrome in Multifetal Gestation between 24 and 34 Weeks

Effect of Repeated Doses of Dexamethasone on the Incidence and Severity of Respiratory Distress Syndrome in Multifetal Gestation between 24 and 34 Weeks

Narrowing of Sex Differences in Infant Mortality in Massachusetts

Early Dexamethasone Treatment Induces Placental Apoptosis in Sheep

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