Effect of antenatal corticosteroid administration-to-birth interval on maternal and newborn outcomes: a systematic review

McDougall, Annie R A; Aboud, Lily; Lavin, Tina; Cao, Jenny; Dore, Gabrielle; Ramson, Jen; Oladapo, Olufemi T.; Vogel, Joshua P.

doi:10.1016/j.eclinm.2023.101916

Cited by 12 publications

(5 citation statements)

References 68 publications

(151 reference statements)

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“…On the other hand, our findings did not come in line with McDougall et al (16) systematic review, which studied ten trials (4592 mothers; 5018 newborns), 45 cohort research (at least 22,992 females; 30,974 newborns) and two case-control studies (355 mother; 360 babies) and found an optimal administration of ACS to-birth interval, however this interval wasn't identified due to variations in study design.…”

Section: Interpretation Of the Current Findings And Comparison To Sim...contrasting

confidence: 99%

The Safety and Effectiveness of Corticosteroids in Twin Pregnancy

2024

The Egyptian Journal of Hospital Medicine

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Section: Interpretation Of the Current Findings And Comparison To Sim...contrasting

confidence: 99%

The Safety and Effectiveness of Corticosteroids in Twin Pregnancy

2024

The Egyptian Journal of Hospital Medicine

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Section: Discussionmentioning

confidence: 99%

“…Although the interval from administration of antenatal corticosteroids to delivery was outside the scope of our research question, a recent systematic review examining such intervals was unable to determine the optimal timing. 76 unanswered questions and future research Further research with long term follow-up in randomised controlled trials will be critical for term or late preterm infants, and in the meantime potentially for children outside of randomised controlled trials. One study involving teacher assessment of children aged 12 years of a parent who had been randomised to antenatal corticosteroids at term gestation, found a doubling of the risk of being in the lower quartile of academic ability compared with children whose parent received placebo (8.5% v 17.7%, P=0.03).…”

Section: Meaning Of the Studymentioning

confidence: 99%

The proportions of term or late preterm births after exposure to early antenatal corticosteroids, and outcomes: systematic review and meta-analysis of 1.6 million infants

Ninan,

Gojic,

Wang

et al. 2023

BMJ

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Objective To systematically review the proportions of infants with early exposure to antenatal corticosteroids but born at term or late preterm, and short term and long term outcomes. Design Systematic review and meta-analyses. Data sources Eight databases searched from 1 January 2000 to 1 February 2023, reflecting recent perinatal care, and references of screened articles. Eligibility criteria for selecting studies Randomised controlled trials and population based cohort studies with data on infants with early exposure to antenatal corticosteroids (<34 weeks) but born at term (≥37 weeks), late preterm (34-36 weeks), or term/late preterm combined. Data extraction and synthesis Two reviewers independently screened titles, abstracts, and full text articles and assessed risk of bias (Cochrane risk of bias tool for randomised controlled trials and Newcastle-Ottawa scale for population based studies). Reviewers extracted data on populations, exposure to antenatal corticosteroids, and outcomes. The authors analysed randomised and cohort data separately, using random effects meta-analyses. Main outcome measures The primary outcome was the proportion of infants with early exposure to antenatal corticosteroids but born at term. Secondary outcomes included the proportions of infants born late preterm or term/late preterm combined after early exposure to antenatal corticosteroids and short term and long term outcomes versus non-exposure for the three gestational time points (term, late preterm, term/late preterm combined). Results Of 14 799 records, the reviewers screened 8815 non-duplicate titles and abstracts and assessed 713 full text articles. Seven randomised controlled trials and 10 population based cohort studies (1.6 million infants total) were included. In randomised controlled trials and population based data, ∼40% of infants with early exposure to antenatal corticosteroids were born at term (low or very low certainty). Among children born at term, early exposure to antenatal corticosteroids versus no exposure was associated with increased risks of admission to neonatal intensive care (adjusted odds ratio 1.49, 95% confidence interval 1.19 to 1.86, one study, 5330 infants, very low certainty; unadjusted relative risk 1.69, 95% confidence interval 1.51 to 1.89, three studies, 1 176 022 infants, I 2 =58%, τ 2 =0.01, low certainty), intubation (unadjusted relative risk 2.59, 1.39 to 4.81, absolute effect 7 more per 1000, 95% confidence interval from 2 more to 16 more, one study, 8076 infants, very low certainty, one study, 8076 infants, very low certainty), reduced head circumference (adjusted mean difference −0.21, 95% confidence interval −0.29 to −0.13, one study, 183 325 infants, low certainty), and any long term neurodevelopmental or behavioural disorder in population based studies (eg, any neurodevelopmental or behavioural disorder in children born at term, adjusted hazard ratio 1.47, 95% confidence interval 1.36 to 1.60, one study, 641 487 children, low certainty). Conclusions About 40% of infants exposed to early antenatal corticosteroids were born at term, with associated adverse short term and long term outcomes (low or very low certainty), highlighting the need for caution when considering antenatal corticosteroids. Systematic review registration PROSPERO CRD42022360079.

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“…They confer benefits by crossing the placenta and accelerating structural maturation of fetal lung tissue and other organs.5,6 The 2020 update of the Cochrane review on ACS efficacy found that ACS use significantly reduces the risk of moderate/severe respiratory distress, perinatal death and neonatal death, and probably reduces the risk of intraventricular haemorrhage (IVH) and developmental delay in childhood.7 WHO currently recommends that ACS should be administered to women between 24 and 34 weeks' gestation who are at risk of imminent preterm birth, provided that certain criteria related to a minimum level of maternal and preterm newborn care can be met. 14,15…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Long Term Outcomes Associated With Preterm Exposure to Antenatal Corticosteroids : A Systematic Review

Rajagukguk

2023

JARMHS

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The aim: This study aims to show about evaluation of long term outcomes associated with preterm exposure to antenatal corticosteroids. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up to date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and SagePub, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 117 articles, whereas the results of our search on SagePub brought up 112 articles. The results of the search conducted for the last year of 2013 yielded a total 91 articles for PubMed and 66 articles for SagePub. The result from title screening, a total 2 articles for PubMed and 11 articles for SagePub. In the end, we compiled a total of 8 papers. We included five research that met the criteria. Conclusion: Numerous studies have shown no evidence of long-term harm (and in fact showed improved survival and neurodevelopmental outcomes with long-term pulmonary and others benefit), particulary as it relates to a single course of corticosteroids administered at less than 34 weeks of gestation.

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Effect of antenatal corticosteroid administration-to-birth interval on maternal and newborn outcomes: a systematic review

Cited by 12 publications

References 68 publications

The Safety and Effectiveness of Corticosteroids in Twin Pregnancy

The Safety and Effectiveness of Corticosteroids in Twin Pregnancy

The proportions of term or late preterm births after exposure to early antenatal corticosteroids, and outcomes: systematic review and meta-analysis of 1.6 million infants

Evaluation of Long Term Outcomes Associated With Preterm Exposure to Antenatal Corticosteroids : A Systematic Review

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