Avoiding the prenatal programming effects of glucocorticoids: are there alternative treatments for the induction of antenatal lung maturation?

Justus, G; Sloboda, Deborah M.; Henrich, Wolfgang; Plagemann, Andreas; Dudenhausen, Joachim W.; Braun, Thorsten

doi:10.1515/jpm-2014-0295

Cited by 9 publications

(3 citation statements)

References 117 publications

(169 reference statements)

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“…Antenatal steroidler fetal surfaktanın yapısında bulunan fosfolipid ve protein metabolizması üzerine direkt etki göstererek akciğer matürasyonunu hızlandırırlar (6). Ayrıca steroidler fetal tiroid hormonu aktivitesini artırarak fetal akciğer matürasyonunu indirekt olarak da hızlandırabilmektedir (7).…”

Section: Yazarların Katkısı / Contribution Of the Authors: Anik Aunclassified

Preterm Bebeklerde Antenatal Betametazon Tedavisinin Serum Tiroid Hormon Düzeylerine Etkisi

Anık¹,

Vurmaz²,

Öztürk³

et al. 2020

Turkish Journal of Pediatric Disease

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Yenidoğan ölümleri ve ağır morbiditelerini azaltan antenatal betametazon tedavisinin preterm bebeklerdeki serum tiroid hormonlarına etkisinin araştırılması amaçlanmıştır.Gereç ve Yöntemler: 2013-2019 yılları arasında doğan ve gebelik haftası 32 hafta ve altında olan ve çalışmaya alınma kriterlerini karşılayan toplam 156 bebek bu retrospektif çalışmaya alındı. Bebeklerin bilgilerine hastane kayıt sisteminden ulaşıldı. Bebekler hiç steroid almayan, tek doz alan ve tam doz alan olmak üzere üç gruba ayrıldı. Yaşamın 30. gününden önce bakılan tiroid fonksiyon testleri karşılaştırıldı.Bulgular: Doğum haftası, doğum şekli, doğum ağırlığı, çoğul gebelik durumu, cinsiyet, anne yaşı, preeklampsi, erken membran rüptürü, koriyoamniyonit, annede tiroid hastalığı, bebeğin hastanede kalma süresi, tiroid testi örneklem zamanı, Apgar skoru, patent duktus arteriyozus, nekrotizan enterokolit, intraventriküler kanama, prematüre retinopatisi ve bronkopulmoner displazi oranı açısından her üç grup arasında fark saptanmadı. Tam doz steroid alanlarda surfaktan ihtiyacı anlamlı olarak düşüktü. Serum serbest tiroksin (sT4) ve tiroid uyarıcı hormon (TSH) düzeyleri açısından her üç grup arasında fark saptanmadı.Sonuç: Bu çalışmada preterm bebeklerde antenatal betametazon profilaksisinin serum tiroid hormonlarına etkisinin olmadığı görülmüştür.

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Section: Yazarların Katkısı / Contribution Of the Authors: Anik Aunclassified

Preterm Bebeklerde Antenatal Betametazon Tedavisinin Serum Tiroid Hormon Düzeylerine Etkisi

Anık¹,

Vurmaz²,

Öztürk³

et al. 2020

Turkish Journal of Pediatric Disease

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“…In pregnancies threatened with preterm birth, antenatal steroid (ANS) treatment to induce fetal lung maturation and to reduce neonatal morbidity and mortality is common practice [1] and appropriate alternatives currently do not exist [2]. We have previously shown that ANS treatment in normally grown singleton and twin pregnancies reduced in a dose-dependent and sex-specific manner fetal weight gain, length and head circumference compared with gestational age-matched controls [3,4].…”

Section: Introductionmentioning

confidence: 99%

Long term alterations of growth after antenatal steroids in preterm twin pregnancies

Braun

Filleböck

Metze

et al. 2020

Journal of Perinatal Medicine

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ObjectivesTo compare the long-term effects of antenatal betamethasone (ANS, ≤16 mg, =24 mg and >24 mg) in twins on infant and childhood growth.MethodsA retrospective cohort follow up study among 198 twins after ANS including three time points: U1 first neonatal examination after birth and in the neonatal period; U7 examination from the 21st to the 24th month of life and U9 examination from the 60th to the 64th month of life using data from copies of the children’s examination booklets. Inclusion criteria are twin pregnancies with preterm labor, cervical shortening, preterm premature rupture of membranes, or vaginal bleeding, and exposure to ANS between 23+5 and 33+6 weeks. Outcome measures are dosage-dependent and sex-specific effects of ANS on growth (body weight, body length, head circumference, body mass index and ponderal index) up to 5.3 years.ResultsOverall, 99 live-born twin pairs were included. Negative effects of ANS on fetal growth persisted beyond birth, altered infant and childhood growth, independent of possible confounding factors. Overall weight percentile significantly decreased between infancy and early childhood by 18.8%. Birth weight percentiles significantly changed in a dose dependent and sex specific manner, most obviously in female-female and mixed pairs. The ponderal index significantly decreased up to 42.9%, BMI index increased by up to 33.8%.ConclusionsANS results in long-term alterations in infant and childhood growth. Changes between infancy and early childhood in ponderal mass index and BMI, independent of dose or twin pair structure, might indicate an ANS associated increased risk for later life disease.SynopsisFirst-time report on long-term ANS administration growth effects in twin pregnancies, showing persisting alterations beyond birth in infant and childhood growth up to 5.3 years as potential indicator of later life disease risk.

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“…Another study reports that maternal serum concentrations of magnesium are lower following MgS04 infusion in mothers with twins compared with singleton gestations which may help account for the lesser neuroprotective effects of this agent in multiple gestations [16]. Finally, Justus and colleagues examine the full gamut of alternatives to corticosteroids for enhancing lung maturity and present these agents' risk benefit data in either animal studies or human clinical trials [17]. Taken together, the current issue of the Journal of Perinatal Medicine contains rich offerings for clinicians and clinical researchers interested in reducing the perinatal morbidity and mortality attendant preterm birth.…”

mentioning

confidence: 99%

Risk factors for preterm birth and new approaches to its early diagnosis

Lockwood

2015

Journal of Perinatal Medicine

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Avoiding the prenatal programming effects of glucocorticoids: are there alternative treatments for the induction of antenatal lung maturation?

Abstract: The efficacy and safety of these alternative agents are differentiated and none up to now can be recommended as an alternative to GCs.

Cited by 9 publications

References 117 publications

Preterm Bebeklerde Antenatal Betametazon Tedavisinin Serum Tiroid Hormon Düzeylerine Etkisi

Preterm Bebeklerde Antenatal Betametazon Tedavisinin Serum Tiroid Hormon Düzeylerine Etkisi

Long term alterations of growth after antenatal steroids in preterm twin pregnancies

Risk factors for preterm birth and new approaches to its early diagnosis

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