Document Detail


Antenatal steroids for treatment of fetal lung immaturity after 34 weeks of gestation: an evaluation of neonatal outcomes.
MedLine Citation:
PMID:  22525901     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate whether antenatal corticosteroids given after fetal lung immaturity in pregnancies at 34 weeks of gestation or more would improve neonatal outcomes and, in particular, respiratory outcomes.
METHODS: We compared outcomes of 362 neonates born at 34 weeks of gestation or more after fetal lung maturity testing: 102 with immature fetal lung indices were treated with antenatal corticosteroids followed by planned delivery within 1 week; 76 with immature fetal lung indices were managed expectantly; and 184 were delivered after mature amniocentesis. Primary outcomes were composites of neonatal and respiratory morbidity.
RESULTS: Compared with corticosteroid-exposed neonates those born after mature amniocentesis had lower rates of adverse neonatal (26.5% compared with 14.1%, adjusted odds ratio [OR] 0.51, 95% confidence interval [CI] 0.27-0.96) and adverse respiratory outcomes (9.8% compared with 3.3%, adjusted OR 0.33, 95% CI 0.11-0.98); newborns born after expectant management had significantly less respiratory morbidity (1.3% compared with 9.8%, adjusted OR 0.11, 95% CI 0.01-0.92) compared with corticosteroid-exposed newborns.
CONCLUSION: Administration of antenatal corticosteroids after immature fetal lung indices did not reduce respiratory morbidity in neonates born at 34 weeks of gestation or more. Our study supports prolonging gestation until delivery is otherwise indicated.
LEVEL OF EVIDENCE: II.
Authors:
Beena D Kamath-Rayne; Emily A DeFranco; Michael P Marcotte
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  119     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-24     Completed Date:  2012-07-27     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  909-16     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniocentesis
Betamethasone / therapeutic use*
Cohort Studies
Dexamethasone / therapeutic use*
Female
Fetal Organ Maturity*
Gestational Age
Glucocorticoids / therapeutic use*
Humans
Infant, Newborn
Lung / embryology*
Pregnancy
Premature Birth
Respiratory Distress Syndrome, Newborn / prevention & control*
Retrospective Studies
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K12 HD051953/HD/NICHD NIH HHS; UL1 TR000077/TR/NCATS NIH HHS; UL1-RR026314-01/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Glucocorticoids; 7S5I7G3JQL/Dexamethasone; 9842X06Q6M/Betamethasone
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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