Who remains undelivered more than seven days after a single course of prenatal corticosteroids and gives birth at less than 34 weeks?

McLaughlin, K. John; Crowther, CA; Vigneswaran, Prasha; Hancock, Elizabeth G; Willson, Kristyn

doi:10.1111/j.0004-8666.2002.00353.x

Cited by 26 publications

(14 citation statements)

References 11 publications

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“…Further, our in-depth side-study has reported no increase in physiologic risk factors for cardiovascular or metabolic disease at early school age. 39 Although our trial sample was representative of women at ongoing risk of preterm birth after an initial course of corticosteroids, 40 caution is required in generalizing our results to other treatment protocols or inclusion criteria. The recent Cochrane systematic review included 9 other randomized trials of repeat antenatal corticosteroid treatment, with varying number, frequency, and dose(s) of corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

Mid-Childhood Outcomes of Repeat Antenatal Corticosteroids: A Randomized Controlled Trial

et al. 2016

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To assess if exposure to repeat dose(s) of antenatal corticosteroids has beneficial effects on neurodevelopment and general health in mid-childhood, at 6 to 8 years' corrected age. METHODS:Women at risk for very preterm birth, who had received a course of corticosteroids ≥7 days previously, were randomized to intramuscular betamethasone (11.4 mg Celestone Chronodose) or saline placebo, repeated weekly if risk of very preterm birth remained. Midchildhood assessments included neurocognitive function, behavior, growth, lung function, blood pressure, health-related quality of life, and health service utilization. The primary outcome was survival free of neurosensory disability. RESULTS:Of the 1059 eligible long-term survivors, 963 (91%) were included in the primary outcome; 479 (91%) in the repeat corticosteroid group and 484 (91%) in the placebo group. The rate of survival free of neurosensory disability was similar in both groups (78.3% repeat versus 77.3% placebo; risk ratio 1.00, 95% confidence interval, 0.94-1.08). Neurodevelopment, including cognitive function, and behavior, body size, blood pressure, spirometry, and health-related quality of life were similar in both groups, as was the use of health services. CONCLUSIONS:Treatment with repeat dose(s) of antenatal corticosteroids was associated with neither benefit nor harm in mid-childhood. Our finding of long-term safety supports the use of repeat dose(s) of antenatal corticosteroids, in view of the related neonatal benefits. For women at risk for preterm birth before 32 weeks' gestation, ≥7 days after an initial course of antenatal corticosteroids, clinicians could consider using a single injection of betamethasone, repeated weekly if risk remains.

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Section: Discussionmentioning

confidence: 99%

Mid-Childhood Outcomes of Repeat Antenatal Corticosteroids: A Randomized Controlled Trial

et al. 2016

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“…McLaughlin and colleagues also looked at the accuracy of physicians in timing the administration of antenatal corticosteroids. 58 Overall, women treated before 28 weeks gestation were more likely to give birth more than seven days later than those treated after 28 weeks. It is difficult to say if that data reflects a quicker tendency by physicians to treat patients at risk of preterm birth at earlier gestations for fear of adverse neonatal outcomes, or an actual difference in likelihood to deliver between these groups.…”

Section: Timing Of Effectivenessmentioning

confidence: 93%

Antenatal Corticosteroids in the Management of Preterm Birth: Are We Back Where We Started?

Bonanno

Wapner

2012

Obstetrics and Gynecology Clinics of North America

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“…Unfortunately, obstetricians are limited in their ability to predict preterm delivery with such accuracy with approximately 50% of patients given an initial course of antenatal corticosteroids remaining undelivered 7–10 days later [66]. Women treated prior to 28 weeks gestation appear more likely to give birth more than seven days later than those treated after 28 weeks [67]. …”

Section: Repeated or Rescue Coursesmentioning

confidence: 99%

Controversy: Antenatal Steroids

Wapner

Jobe

2011

Clinics in Perinatology

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Who remains undelivered more than seven days after a single course of prenatal corticosteroids and gives birth at less than 34 weeks?

Abstract: Women who give birth very preterm, who remain undelivered more than seven days after prenatal corticosteroids, differ in the reasons for and timing of their first course from women who give birth within seven days.

Cited by 26 publications

References 11 publications

Mid-Childhood Outcomes of Repeat Antenatal Corticosteroids: A Randomized Controlled Trial

Mid-Childhood Outcomes of Repeat Antenatal Corticosteroids: A Randomized Controlled Trial

Antenatal Corticosteroids in the Management of Preterm Birth: Are We Back Where We Started?

Controversy: Antenatal Steroids

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