Document Detail


Rescue corticosteroids in twin pregnancies and short-term neonatal outcomes.
MedLine Citation:
PMID:  23121189     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Please cite this paper as: Bibbo C, Deluca L, Gibbs K, Saltzman D, Rebarber A, Green R, Fox N. Rescue corticosteroids in twin pregnancies and short-term neonatal outcomes. BJOG 2012; DOI: 10.1111/1471-0528.12021. Objective  To estimate the efficacy of a rescue course of antenatal corticosteroids in twin pregnancies. Design  Retrospective cohort study. Setting  Tertiary-care centre. Population  Twins born from 24 to <34 weeks of gestation in a single maternal and fetal medicine practice from 2006 to 2011. Methods  We compared neonatal outcomes in 88 twins exposed to a single course of corticosteroids with outcomes in 42 twins exposed to two courses of corticosteroids: the initial course and a single rescue course. Analyses were adjusted to control for correlation between twins born to the same mother. Main outcome measure  Short-term neonatal respiratory morbidity. Results  Rescue corticosteroids were associated with fewer days of mechanical ventilation (7.3 ± 3.3 versus 33.9 ± 25.3 days, P = 0.003), fewer days with a fraction of inspired oxygen of >21% (6.3 ± 4.3 versus 33.3 ± 25.8 days, P = 0.003), a lower incidence of mechanical ventilation >14 days or death while on mechanical ventilation (0 versus 12.5%, P = 0.016), and a lower incidence of retinopathy of prematurity (0 versus 12.5%, P = 0.016). The proportion of neonates with respiratory distress syndrome did not differ between the groups (adjusted odds ratio 1.28, 95% confidence interval 0.50-3.26). There were no differences found for birthweight, head circumference and length. Conclusions  In twins born before 34 weeks of gestation, exposure to rescue corticosteroids may be associated with improved neonatal outcomes. Further studies are warranted to assess the effect of rescue corticosteroids in twin pregnancies.
Authors:
C Bibbo; L Deluca; Ka Gibbs; Dh Saltzman; A Rebarber; Rs Green; Ns Fox
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-2
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  -     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.
Affiliation:
Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA Division of Newborn Medicine, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY, USA Maternal Fetal Medicine Associates, PLLC, New York, NY, USA.
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