Association Between Antenatal Corticosteroid Administration-to-Birth Interval and Outcomes of Preterm Neonates

Melamed, Nir; Shah, Jyotsna; Soraisham, Amuchou; Yoon, Eugene W.; Lee, Shoo K.; Shah, Prakesh S.; Murphy, Kellie

doi:10.1097/aog.0000000000000840

Cited by 101 publications

(92 citation statements)

References 30 publications

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“…Pulmonary deterioration was associated with several antecedents and clinical factors at univariate analysis; some of these were reported by previous studies [12,13,14,15,16,17,18,19], while to our knowledge the potential protective role of human milk is a novel finding that needs to be confirmed by other studies. …”

Section: Discussionmentioning

confidence: 61%

New Insights on Early Patterns of Respiratory Disease among Extremely Low Gestational Age Newborns

et al. 2017

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Background: The analysis of early patterns of lung disease among preterm infants may help to identify predictors of pulmonary deterioration. Objectives: To analyze FIO₂ requirement in the first 14 days of life among preterm infants and to find predictors of bronchopulmonary dysplasia (BPD). Methods: Retrospective cohort study. Setting: 3 Italian level III NICUs. Population: infants born between 24^0/7 and 27^6/7 weeks' gestational age (GA) who survived to 14 days. A consecutive sample of 588 infants was analyzed. Daily mode FIO₂ in the first 2 weeks of life were analyzed according to the criteria defined by Laughon et al. [Pediatrics 2009;123:1124-1131], who found 3 early respiratory patterns: consistently low FIO₂ (LowFIO₂), pulmonary deterioration (PD), and early persistent pulmonary deterioration (EPPD). Factors associated with pulmonary deterioration were studied by univariate and multivariate analysis. Results: Forty percent of infants had low FIO₂, 18% had pulmonary deterioation, 21% had early persistent pulmonary deterioration, and 21% had a previously unreported pattern (pulmonary improvement, PI). The prevalence of BPD was 7% in the LowFIO₂ group, 28% in the PI group, 44% in the PD group, and 62% in the EPPD group (p = 0.000). Infants with lung deterioration were more frequently males (OR = 2.019, CI: 1.319-3.090, p = 0.001), had lower GA (OR = 0.945, CI: 0.915-0.975, p = 0.000), higher incidence of severe respiratory distress syndrome (OR = 2.956, CI: 1.430-6.112, p = 0.003), and lack of postnatal caffeine (OR = 0.167, CI: 0.052-0.541, p = 0.003). Conclusions: We report 4 distinct patterns of early respiratory disease associated with significantly different prevalence of BPD and discuss risk factors for lung deterioration.

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Section: Discussionmentioning

confidence: 61%

New Insights on Early Patterns of Respiratory Disease among Extremely Low Gestational Age Newborns

et al. 2017

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“…The association between timing of ACS and outcomes among extremely preterm infants has been sparsely investigated. In a recent large retrospective cohort study, higher odds for severe neonatal morbidity or mortality were seen in infants born at 24–33 weeks gestation with an administration-to-birth interval of ACS <1 or>7 days compared with 1–7 days 2. The objective of this study was to investigate the impact of ACS administration-to-birth interval on survival among extremely preterm infants.…”

Section: Contextmentioning

confidence: 99%

Antenatal corticosteroid administration between 24 hours and 7 days before extremely preterm delivery is associated with the lowest rate of mortality

Travers

Carlo

2017

Evid Based Med

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“…17,18 However, there are concerns regarding adverse effects of steroids on the developing brain. 19 We will determine whether optimal antenatal administration of steroids is associated with improved neurodevelopmental outcomes for neonates.…”

Section: Antenatal Steroid Administrationmentioning

confidence: 99%

The Canadian Preterm Birth Network: a study protocol for improving outcomes for preterm infants and their families

et al. 2018

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P reterm birth, defined as birth occurring before 37 weeks' gestation, occurs in about 8% of pregnancies in Canada 1 and has a life-long impact on babies, their families and society. As the leading cause of infant death, cerebral palsy and disability, preterm birth is estimated to cost the Canadian health care system over $8 billion per year.2 Previous studies by our group showed that, by applying collaborative, integrated quality improvement via networking, the incidence of major neonatal morbidity decreased by 20%-50% in infants less than 29 weeks of gestational age. [3][4][5] Outcome improvements to date have used data platforms limited to neonatal and neonatal follow-up research 6,7 despite mounting evidence that events before and during pregnancy can have life-long implications for the child. 7,8 Furthermore, our platforms were missing data regarding family integration into preterm birth care, which can positively affect neonatal outcomes. 9 The Canadian Preterm Birth Network (CPTBN), described in this protocol, is funded by the Canadian Institutes of Health Research and aims to expand our existing neonatal platforms to develop a pan-Canadian network consisting of a team with expertise in maternal-fetal medicine, obstetrics, neonatology, The Canadian Preterm Birth Network: a study protocol for improving outcomes for preterm infants and their families Background: Preterm birth (birth before 37 wk of gestation) occurs in about 8% of pregnancies in Canada and is associated with high mortality and morbidity rates that substantially affect infants, their families and the health care system. Our overall goal is to create a transdisciplinary platform, the Canadian Preterm Birth Network (CPTBN), where investigators, stakeholders and families will work together to improve childhood outcomes of preterm neonates. Methods:Our national cohort will include 24 maternal-fetal/obstetrical units, 31 neonatal intensive care units and 26 neonatal follow-up programs across Canada with planned linkages to provincial health information systems. Three broad clusters of projects will be undertaken. Cluster 1 will focus on quality-improvement efforts that use the Evidence-based Practice for Improving Quality method to evaluate information from the CPTBN database and review the current literature, then identify potentially better health care practices and implement identified strategies. Cluster 2 will assess the impact of current practices and practice changes in maternal, perinatal and neonatal care on maternal, neonatal and neurodevelopmental outcomes. Cluster 3 will evaluate the effect of preterm birth on babies, their families and the health care system by integrating CPTBN data, parent feedback, and national and provincial database information in order to identify areas where more parental support is needed, and also generate robust estimates of resource use, cost and cost-effectiveness around preterm neonatal care. Interpretation:These collaborative efforts will create a flexible, transdisciplinary, evaluable and informative r...

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Association Between Antenatal Corticosteroid Administration-to-Birth Interval and Outcomes of Preterm Neonates

Abstract: II.

Cited by 101 publications

References 30 publications

New Insights on Early Patterns of Respiratory Disease among Extremely Low Gestational Age Newborns

New Insights on Early Patterns of Respiratory Disease among Extremely Low Gestational Age Newborns

Antenatal corticosteroid administration between 24 hours and 7 days before extremely preterm delivery is associated with the lowest rate of mortality

The Canadian Preterm Birth Network: a study protocol for improving outcomes for preterm infants and their families

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