Antenatal corticosteroid therapy: Historical and scientific basis to improve preterm birth management

Briceño-Pérez, Carlos; Reyna‐Villasmil, Eduardo; VIGILDEGRACIA, P

doi:10.1016/j.ejogrb.2018.12.025

Cited by 44 publications

(50 citation statements)

References 32 publications

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“…Numerous issues affect a mother’s ability to attend antenatal care [13]. Antenatal corticosteroids (ACS) improve outcomes among newborns [14]. However, their advantages in RRR, where overall newborn care is inadequate, need to be confirmed [15].…”

Section: Rds Management In Rrr Of Ssamentioning

confidence: 99%

Optimal Ventilation and Surfactant Therapy in Very-Low-Birth-Weight Infants in Resource-Restricted Regions

et al. 2020

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In resource-restricted regions, respiratory distress syndrome (RDS) data are often underreported, making the determination of effective interventions and their outcome difficult. The combination of oxygen, nasal continuous positive airway pressure (CPAP) and surfactant therapy has the potential to prevent 42% of RDS-related deaths in sub-Saharan Africa, despite the financial implications. This article provides a brief overview on the status of RDS management, mainly nasal CPAP and surfactant therapy in very-low-birth-weight infants, in resource-restricted regions of sub-Saharan Africa. Data from the public health sector, as compared to the private health sector, of the Western Cape province, South Africa, are used to illustrate what RDS management strategies are able to accomplish in a resource-restricted region. Upscaling of all components (antenatal care, antenatal corticosteroids, prevention of hypothermia and RDS management strategies) are required to decrease premature infant mortality rates in resource-restricted areas.

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Section: Rds Management In Rrr Of Ssamentioning

confidence: 99%

Optimal Ventilation and Surfactant Therapy in Very-Low-Birth-Weight Infants in Resource-Restricted Regions

et al. 2020

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“…In human pregnancies, antenatal GC therapy is indicated for mothers at risk of preterm delivery between gestational weeks 24 and 34, without any specification of the administration time. GCs accelerate fetal lung maturation and reduce the risk of respiratory distress syndrome, the main cause of mortality in premature babies [24][25][26] . While substantially improving the short-term outcome of the newborns, antenatal GC treatment has also been associated with an increased vulnerability for developing stressrelated disorders later in life 27,28 .…”

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confidence: 99%

The circadian phase of antenatal glucocorticoid treatment affects the risk of behavioral disorders

et al. 2020

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During pregnancy, maternal endocrine signals drive fetal development and program the offspring's physiology. A disruption of maternal glucocorticoid (GC) homeostasis increases the child's risk of developing psychiatric disorders later in life. We here show in mice, that the time of day of antenatal GC exposure predicts the behavioral phenotype of the adult offspring. Offspring of mothers receiving GCs out-of-phase compared to their endogenous circadian GC rhythm show elevated anxiety, impaired stress coping, and dysfunctional stressaxis regulation. The fetal circadian clock determines the vulnerability of the stress axis to GC treatment by controlling GC receptor (GR) availability in the hypothalamus. Similarly, a retrospective observational study indicates poorer stress compensatory capacity in 5-year old preterm infants whose mothers received antenatal GCs towards the evening. Our findings offer insights into the circadian physiology of feto-maternal crosstalk and assign a role to the fetal clock as a temporal gatekeeper of GC sensitivity.

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“…Usualmente, ante una paciente con posibilidad real de nacimiento prematuro, específicamente entre las 24 y 37 semanas, se sugiere la administración de corticoides en dosis total de 24 mg (2 dosis de betametasona o 4 dosis de dexametasona) (21) . No existen aún estudios en embarazadas con COVID-19 en relación con uso o no de corticoides; sin embargo, en los casos descritos se los ha utilizado para madurez fetal (3,15) .…”

Section: Uso De Corticoidesunclassified

COVID-19 y embarazo. Revisión y actualización

Gracia¹,

Caballero²,

Chinkee³

et al. 2020

Rev peru ginecol obstet.

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Objetivo. Buscar toda la información y evidencia disponible sobre el SARS-CoV-2 -que surgió en estos primeros 4 meses de 2020- y el embarazo. Metodología. Revisión sistemática en las bases de datos PubMed y Google Scholar, hasta el 25 de abril de 2020. Se buscó artículos publicados relacionados con mujeres embarazadas infectadas con SARS-CoV-2. No hubo restricción de idioma. La búsqueda se extendió a las referencias de los artículos encontrados. Resultados. La enfermedad COVID-19 en mujeres embarazadas se caracteriza porque más del 90% de las pacientes evoluciona en forma leve, 2% requiere ingresar a las unidades de cuidados intensivos. Una muerte materna ha sido reportada. La prematuridad es alrededor de 25%, con predominio de recién nacidos prematuros tardíos; aproximadamente el 9% se complica con rotura prematura de membranas; la mortalidad perinatal es baja o similar a la de la población general y no se ha demostrado la transmisión vertical. Conclusiones. Los ginecólogos obstetras deben prepararse para atender cada vez más casos con COVID-19 y, por lo tanto, es necesario tener su conocimiento. La enfermedad evoluciona de la misma manera que en las no embarazadas, genera mayor prematuridad, no se ha demostrado la transmisión vertical, pero hay altas posibilidades de transmisión horizontal durante el parto vaginal.

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Antenatal corticosteroid therapy: Historical and scientific basis to improve preterm birth management

Cited by 44 publications

References 32 publications

Optimal Ventilation and Surfactant Therapy in Very-Low-Birth-Weight Infants in Resource-Restricted Regions

Optimal Ventilation and Surfactant Therapy in Very-Low-Birth-Weight Infants in Resource-Restricted Regions

The circadian phase of antenatal glucocorticoid treatment affects the risk of behavioral disorders

COVID-19 y embarazo. Revisión y actualización

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