Effectiveness of Antenatal Steroids in Obstetric Subgroups

Elimian, Andrew; Verma, Uma; Canterino, Joseph; Shah, Jalpa; Visintainer, Paul; Tejani, Nergesh

doi:10.1097/00006250-199902000-00003

Cited by 32 publications

(44 citation statements)

References 18 publications

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“…The prevalence of small for gestational age infants is higher in the medically indicated preterm birth group than in the other two 14,15 . The effectiveness of antenatal steroids seems to depend on the clinical subtype of preterm birth, with the greatest effect observed in the adequate for gestational age infant delivered after preterm labour with intact membranes and the least effect in cases of pregnancy associated with maternal hypertension or fetal growth restriction 16 .…”

Section: Introductionmentioning

confidence: 99%

Singleton preterm births in Korle bu teaching hospital, Accra, Ghana – origins and outcomes

Nkyekyer¹,

Enweronu‐Laryea²,

Boafor³

2010

Ghana Medical Journal

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SUMMARYObjective: To determine the singleton preterm birth rate, the relative proportions of the clinical categories of preterm births and to compare the outcomes in these categories. .1%]) were medically indicated (group C). The commonest indication for delivery in group C was severe pre-eclampsia/eclampsia. Although there was no significant difference in the mean gestational ages at delivery between the groups, babies in group C had significantly lower birth weights. No differences in sex ratios, stillbirth rates, or incidence of low Apgar scores were found. Babies in group C were significantly more likely to be admitted to the neonatal intensive care unit (NICU) and had a significantly higher perinatal death rate. Survivors of NICU admission among group C babies spent significantly longer periods in hospital before discharge. Conclusion:Outcomes of preterm births in Korle Bu Teaching Hospital are less favourable among indicated preterm births than among spontaneous or PPROM-related preterm births. A detailed study of the causes of neonatal morbidity and mortality is suggested to determine any differences between the three groups.

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Section: Introductionmentioning

confidence: 99%

Singleton preterm births in Korle bu teaching hospital, Accra, Ghana – origins and outcomes

Nkyekyer¹,

Enweronu‐Laryea²,

Boafor³

2010

Ghana Medical Journal

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“…16 17 Many trials of antenatal steroid treatment before this meta-analysis [18][19][20] and other studies of risk factors for neonatal RDS did not consider smoking in pregnancy. [21][22][23] Therefore, to the best of our knowledge, the differential effect of antenatal steroids on RDS in neonates born to smokers and non-smokers has not yet been studied. In western countries, very preterm births (before 33 completed weeks of amenorrhoea) account for 1-2% of live births.…”

mentioning

confidence: 99%

Does smoking in pregnancy modify the impact of antenatal steroids on neonatal respiratory distress syndrome? Results of the Epipage study

Burguet

2005

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Objectives: To assess the relation between cigarette smoking during pregnancy and neonatal respiratory distress syndrome (RDS) in very preterm birth, and to analyse the differential effect of antenatal steroids on RDS among smokers and non-smokers. Design: A population based cohort study (the French Epipage study). Setting: Regionally defined births in France. Methods: A total of 858 very preterm liveborn singletons (27-32 completed weeks of gestation) of the French Epipage study were included in this analysis. The odds ratio for RDS in relation to smoking in pregnancy was estimated using a logistic regression to control for gestational age. The odds ratio for RDS in relation to antenatal steroids was estimated taking into account an interaction between antenatal steroids and cigarette smoking, using multiple logistic regression to control for gestational age, birthweight ratio, main causes of preterm birth, mode of delivery, and sex. Results: The odds ratio for RDS in relation to smoking in pregnancy adjusted for gestational age (aOR) was 0.59 (95% confidence interval (CI) 0.44 to 0.79). The aOR for RDS in relation to antenatal steroids was 0.31 (95% CI 0.19 to 0.49) in babies born to non-smokers and 0.63 (95% CI 0.38 to 1.05) in those born to smokers; the difference was significant (p = 0.04). Conclusions: Cigarette smoking during pregnancy is associated with a decrease in the risk of RDS in very preterm babies. Although antenatal steroids reduce the risk of RDS in babies born to both smokers and non-smokers, the reduction is smaller in those born to smokers.

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“…Conversely, in the developing world they are often omitted 6. Strong evidence exists for the role of antenatal steroids in reducing the incidence of respiratory distress syndrome, intraventricular haemorrhage, periventricular leukomalacia and necrotising enterocolitis in premature infants 7 8. Even incomplete courses of antenatal steroids have been shown to give some benefits to extremely premature infants 9.…”

Section: Global Health Problem Analysismentioning

confidence: 99%

Miracle baby: managing extremely preterm birth in rural Uganda

et al. 2014

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Preterm birth is an important cause of neonatal morbidity and mortality globally. Uganda has one of the highest rates of preterm birth in East Africa but few resources to care for these infants. This case highlights the clinical course of an extremely premature infant born at 26 weeks gestation to a nulliparous 24-year-old woman. Her mother was involved in her care and taught the principles of kangaroo mother care. After initial problems establishing feeds she progressed well and was discharged in the fifth week of life. The case describes some of the low technology conservative and medical measures which can be used to care for neonates, such as antenatal steroids and kangaroo care. The use of antibiotics and aminophylline are also discussed. The approach to the common challenges faced by premature infants such as respiratory disease, sepsis and necrotising enterocolitis in a resource-poor environment are discussed.

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Effectiveness of Antenatal Steroids in Obstetric Subgroups

Cited by 32 publications

References 18 publications

Singleton preterm births in Korle bu teaching hospital, Accra, Ghana – origins and outcomes

Singleton preterm births in Korle bu teaching hospital, Accra, Ghana – origins and outcomes

Does smoking in pregnancy modify the impact of antenatal steroids on neonatal respiratory distress syndrome? Results of the Epipage study

Miracle baby: managing extremely preterm birth in rural Uganda

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