Document Detail


Antenatal steroids, delivery mode, and intraventricular hemorrhage in preterm infants.
MedLine Citation:
PMID:  7892866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The relationship between antenatal steroids, delivery mode, and early-onset intraventricular hemorrhage was examined in very-low-birth-weight infants. STUDY DESIGN: A total of 505 preterm infants (birth weight 600 to 1250 gm) were enrolled in a multicenter, prospectively randomized, controlled trial evaluating the efficacy of postnatal indomethacin to prevent intraventricular hemorrhage. All infants had echoencephalography between 5 and 11 hours of life. RESULTS: Seventy-three infants had intraventricular hemorrhage within the first 5 to 11 hours (mean age at echoencephalography 7.5 hours). Four hundred thirty-two infants did not have early intraventricular hemorrhage. There was less antenatal steroid treatment (19% vs 32%, p = 0.03) and more vaginal deliveries (71% vs 45%, p < 0.0001) in the group with early intraventricular hemorrhage. Of 152 infants who received antenatal steroids, those delivered by cesarean section had significantly less early-onset intraventricular hemorrhage than did those delivered vaginally (4% vs 17%, p = 0.02). Of the 353 not exposed to antenatal steroids, 10% of infants delivered by cesarean section and 22% delivered vaginally had early intraventricular hemorrhage (p = 0.003). CONCLUSION: These data are the first to suggest that both antenatal steroids and cesarean section delivery have an important and independent role in lowering the risk of early-onset intraventricular hemorrhage.
Authors:
L R Ment; W Oh; R A Ehrenkranz; A G Philip; C C Duncan; R W Makuch
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  172     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-04-14     Completed Date:  1995-04-14     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  795-800     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06510.
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MeSH Terms
Descriptor/Qualifier:
Cerebral Hemorrhage / prevention & control*
Cesarean Section*
Female
Humans
Indomethacin / therapeutic use
Infant, Low Birth Weight*
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / prevention & control*
Logistic Models
Male
Pregnancy
Prenatal Care
Prospective Studies
Steroids / therapeutic use*
Grant Support
ID/Acronym/Agency:
NS 27116/NS/NINDS NIH HHS; NS 32578/NS/NINDS NIH HHS; RR 06022/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Steroids; 53-86-1/Indomethacin

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