| Repeated antenatal corticosteroid treatment: a systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 21426310 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objective. To systematically review the efficacy and safety of repeated antenatal corticosteroid on neonatal morbidity, growth and later development. Search strategy. Medline, Cochrane database and bibliography of identified articles were searched for English language studies. Selection criteria. Randomized, controlled trials studying the efficacy and safety of repeat antenatal corticosteroid on neonatal morbidity and early childhood development. Data collection and analysis. Two reviewers independently assessed titles, abstracts, full studies, extracted data and assessed quality. Meta-analyses were performed calculating risk ratios and weighted differences of means with 95% confidence intervals (CI) using a random effects model. Results. Eight trials were included. Repeat betamethasone decreased the risk of respiratory distress syndrome (RDS) (RR 0.85, 95%CI 0.77-0.93). Trials involving weekly or biweekly repeat betamethasone and those involving a single rescue dose both decreased the risk of RDS. Intrauterine growth was significantly restricted among preterm infants exposed to weekly or biweekly repeat betamethasone. A single rescue course did not affect growth. Four follow-up studies did not reveal any disturbances in neurodevelopment or growth at two years of corrected age. Conclusions. Repeated corticosteroid treatment decreased the risk of RDS among preterm infants. Weekly or biweekly repeated betamethasone restricted intrauterine growth, which raises concerns about long-term consequences on neurodevelopment and metabolism. More follow-up studies are needed to confirm the long-term safety of repeated betamethasone. |
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Authors:
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O M Peltoniemi; M A Kari; M Hallman |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-23 |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: - ISSN: 1600-0412 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 The Authors AOGS© 2011 Nordic Federation of Societies of Obstetrics and Gynecology. |
Affiliation:
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Department of Pediatrics, University of Oulu, Finland Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland. |
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