| 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: 2013-04-26 |
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 |
Affiliation:
|
Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Maternal-Fetal Medicine, University of Cincinnati School of Medicine, Cincinnati, OH 45229, USA. beena.kamath-rayne@cchmc.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| 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; 378-44-9/Betamethasone; 50-02-2/Dexamethasone |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Endometrial Shedding Effect on Conception and Live Birth in Women With Polycystic Ovary Syndrome.
Next Document: Effect of Antenatal Corticosteroids on Fetal Growth and Gestational Age at Birth.