Different corticosteroids and regimens for accelerating fetal lung maturation for babies at risk of preterm birth

Williams, Myfanwy J; Ramson, Jenny A; Brownfoot, Fiona

doi:10.1002/14651858.cd006764.pub4

Cited by 11 publications

(6 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In terms of neonatal mortality, our results are consistent with these findings, in addition, due to the beneficial effects of ACS on the respiratory and cardiovascular systems [10,28], higher 1 min Apgar scores and lower any intubation rates were found in the potentially better ACS interval group, but for chronic lung disease, there was no significant difference between the two groups.…”

Section: Plos Onesupporting

confidence: 90%

“…Despite the widespread use of ACS to prevent adverse neonatal complications in preterm infants, and several national and international clinical practice guidelines also make recommendations for initial prenatal corticosteroid administration, there is currently no consensus as to the type of corticosteroid to use, the dose and frequency of use, the timing of use and the route of administration [10][11][12][13][14]. International guidelines broadly agree that the administration of antenatal corticosteroids should be within 7 days prior to preterm birth.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antenatal corticosteroid administration-to-birth interval and neonatal outcomes in very preterm infants: A secondary analysis based on a prospective cohort study

Zhu

2023

PLoS ONE

View full text Add to dashboard Cite

Introduction Despite the prevalent use of antenatal corticosteroids (ACS) to prevent preterm infants’ adverse neonatal complications, there is currently no consensus on administration-to-birth intervals of ACS. International guidelines broadly agree that the administration of antenatal corticosteroids should be within 7 days prior to preterm birth. However, there is little evidence to support narrower optimal ACS administration-to-birth interval time. This study was undertaken to investigate the association between the administration-to-birth interval of ACS which is bounded by 48 hours and neonatal outcomes in very preterm infants. Materials and methods This is a single-center prospective observational study. Data were collected prospectively from eligible infants from January 2008 to April 2014 at the Santa Clara Valley Medical Center, neonatal outcomes were compared between two groups based on the interval of antenatal corticosteroid administration-to-birth: the interval of <48h, and the interval of >48h. It was noted that the entire study was completed by Dongli Song et al., and uploaded the data to the DATADRYAD website. The author only used this data for secondary analysis. Results After adjusting potential confounders (gestational age, sex, birth weight, duration of cord clamping and delivery mode), the interval of >48h group compared to the interval of <48h group had significant reductions in mortality (OR: 0.17; 95% CI: 0.05–0.59), any retinopathy of prematurity (OR: 0.36; 95% CI: 0.16–0.82), severe retinopathy of prematurity (OR: 0.07; 95% CI: 0.01–0.45), any intubation (OR: 0.39; 95% CI: 0.20–0.75) and higher 1 min Apgar (β: 0.56; 95% CI: 0.10–1.02). Conclusion This study shows that in very preterm infants, compared with the interval of ACS<48h, the interval of ACS>48 hours has a significant health promotion effect.

show abstract

Section: Plos Onesupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Antenatal corticosteroid administration-to-birth interval and neonatal outcomes in very preterm infants: A secondary analysis based on a prospective cohort study

Zhu

2023

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…A low gestational age indicates a low amount of PS, leading to an increased surface tension of the alveoli and decreased FRC at the end of expiration, and alveolar collapse. Some previous studies indicated that the prevalence of preterm infants with age of <32 weeks was about 35–50% [ 16 , 17 ], while other studies reported the rate of up to 80% [ 18 ]. Following the pathophysiological changes in NRDS, the clinical manifestations of patients, blood gas analysis and CXR characteristic imaging changes are the main diagnosis points for this disease, whereas EPS and CPAP/CMV application are the main treatments.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of ultrasound in the diagnosis of neonatal respiratory distress syndrome in preterm infants

Jing

Wang

2023

Journal of Tropical Pediatrics

View full text Add to dashboard Cite

Background The aim of this study was to investigate the feasibility of lung ultrasound in the diagnosis of neonatal respiratory distress syndrome (NRDS) in preterm infants. Methods One hundred and nine preterm infants were prospectively recruited. Three ultrasound diagnostic criteria were developed to diagnose preterm infants with NRDS: (A) thickened or not smooth pleural line, part of the lung field shows diffuse ‘B-line’ sign or alveolar-interstitial syndrome (AIS); (B) thickened or not smooth pleural line, all lung fields show AIS, signifying the ‘white lung’ sign; (C) thickened or rough pleural line, ‘white lung’ sign and ‘lung consolidation’ sign can be observed in any lung field. Results The sensitivity and negative predictive value of NRDS in preterm infants with diagnostic criteria A were 100%, but the specificity and positive predictive value were 67.95 and 55.36%, respectively. The specificity and positive predictive value of diagnostic criteria B and C were 100%, while the 95% CI of diagnostic criteria B was narrower than diagnostic criteria C. The sensitivity and negative predictive value of diagnostic criteria B were higher than that of diagnostic criteria C. Of the 31 NRDS cases, 15 cases had severe NRDS and the other 16 did not have severe NRDS. Conclusion Thickened or rough pleural line with white lung sign is an important characteristic for the diagnosis of NRDS by lung ultrasound. White lung sign combined with the lung consolidation sign had high diagnostic efficacy when distinguishing severe NRDS from not severe NRDS.

show abstract

“…Dexamethasone and betamethasone have been used most widely worldwide. The 2022 Cochrane meta-analyses which included 11 trials found no evidence of a difference between dexamethasone and betamethasone for infant outcomes including RDS, IVH, chronic lung disease, and maternal outcomes like chorioamnionitis ( Williams et al, 2022 ). And as for the long-term child outcomes, there was only a multi-center randomized controlled trial which came up with the conclusion that the incidence of survival without neurosensory disability at age 2 years did not differ between dexamethasone and betamethasone treatment ( Crowther et al, 2019a ).…”

Section: The Choice Of Corticosteroidmentioning

confidence: 99%

The role of antenatal corticosteroids in twin pregnancy

Zhu

Li²,

Zhao³

et al. 2023

Front. Pharmacol.

View full text Add to dashboard Cite

Twin pregnancy was associated with significantly higher rates of adverse neonatal and perinatal outcomes. One of the underlying causes is that twins are prone to preterm birth. Antenatal corticosteroids are widely used for reducing the incidence of neonatal respiratory distress syndrome initially and other neonatal mortality and morbidities subsequently. As it is widely used as a prophylactic treatment for potential premature births, there remain controversies of issues relating to twin gestations, including window for opportunity, timing of use, repeat course, optimal administration-to-delivery intervals, dosage, and type of corticosteroid. Thus, we present a thorough review of antenatal corticosteroids usage in twin gestation, emphasizing the aforementioned issues and attempting to offer direction for future investigation and clinical practice.

show abstract

Different corticosteroids and regimens for accelerating fetal lung maturation for babies at risk of preterm birth

Cited by 11 publications

References 68 publications

Antenatal corticosteroid administration-to-birth interval and neonatal outcomes in very preterm infants: A secondary analysis based on a prospective cohort study

Antenatal corticosteroid administration-to-birth interval and neonatal outcomes in very preterm infants: A secondary analysis based on a prospective cohort study

Feasibility of ultrasound in the diagnosis of neonatal respiratory distress syndrome in preterm infants

The role of antenatal corticosteroids in twin pregnancy

Contact Info

Product

Resources

About