Effectiveness of antenatal steroids in obstetric subgroups

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

doi:10.1016/s0029-7844(98)00400-1

Cited by 70 publications

(32 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, there was no reduction in necrotising enterocolitis or increase in neonatal culture positive sepsis. This is in agreement with Abbasi et al (2000), Thorp et al (2001) and Elimian et al (1999) and in contrast to other studies (Leviton et al 1993;Vermillion et al 1999;Wright et al 1995a). …”

Section: Commentsupporting

confidence: 93%

“…The TRH study showed an impairment of fetal growth but no effect on head circumference (Banks et al 1999), while Abbasi et al (2000) showed a reduction in head circumference and no effect on birth weight. However, Elimian et al (1999) showed no disturbance in growth with multiple AC. In this study, single AC decreased the risk of total intraventricular haemorrhage when compared with both none and multiple AC.…”

Section: Commentmentioning

confidence: 86%

See 1 more Smart Citation

A comparison of the effectiveness of single-dose vs multi-dose antenatal corticosteroids in pre-term neonates

Ogunyemi

2005

Journal of Obstetrics and Gynaecology

View full text Add to dashboard Cite

The purpose of this study was to compare the outcome between exposure to single vs multiple courses of antenatal corticosteroids (AC) in pre-term births. The study involved 704 neonates delivered between 24-32 weeks. Maternal and perinatal outcome were compared between 294 (42%) neonates who received no AC; 257 (36%) who received single AC and 153 (22%) who received multiple AC. Any AC compared with no AC showed decreased composite neonatal morbidity (51% vs 62%, p = 0.004, odds ratio (OR) = 0.6), neonatal death (52% vs 62%, p = 0.004, OR = 0.6) and hyaline membrane disease (45% vs 57%, p = 0.002, OR = 0.6) with increased chorioamnionitis (17% vs 11%, p = 0.037, OR = 1.6) and pulmonary oedema (12% vs 1%, p = 0.0001, OR = 13). Multiple AC compared with single AC was associated with increased positive maternal cultures (44% vs 31%, p < or =0.005, OR = 1.8), small for gestational age infants (35% vs 21%, p = 0.001, OR = 2) and intraventricular haemorrhage (45% vs 34%, p <0.05, OR = 1.6). Multiple corticosteroid courses when compared with single corticosteroid course did not further reduce composite neonatal morbidity but increased the risk of positive maternal cultures and neonatal small for gestational age and intraventricular haemorrhage.

show abstract

Section: Commentsupporting

confidence: 93%

Section: Commentmentioning

confidence: 86%

A comparison of the effectiveness of single-dose vs multi-dose antenatal corticosteroids in pre-term neonates

Ogunyemi

2005

Journal of Obstetrics and Gynaecology

View full text Add to dashboard Cite

show abstract

“…17 Similar results were found in another study of 220 SGA infants weighing ≤1750 g that examined only in-hospital morbidities without examining whether baseline differences in GA existed between the two groups. 18 The same study, however, found improved in-hospital outcomes among appropriate for gestational age infants exposed to ANS compared to those not exposed. 18 In a recent study of singletons and multiples born at 22 to 25 weeks using data from the NICHD NRN, Carlo et al showed that exposure to ANS compared with no exposure was associated with a lower rate of NDI or death among non-SGA infants only; no significant results were seen among SGA infants.…”

Section: Discussionmentioning

confidence: 91%

Association of Antenatal Corticosteroids With Mortality, Morbidity, and Neurodevelopmental Outcomes in Extremely Preterm Multiple Gestation Infants

et al. 2016

View full text Add to dashboard Cite

“…12,17 Growth restriction is not characteristic of all newborn infants exhibiting RDS, and there is conflicting clinical evidence on the extent to which fetal growth restriction increases the risk of neonatal RDS in humans. 44–47 The growth restriction phenotype in Erk3 −/− pups may have an impact on the molecular mechanisms of lung maturation that were detected in this study, potentially limiting its applicability to the subset of neonates with RDS who also experienced IUGR. Another possible limitation is in the incomplete comparison of temporal gene regulation and glucocorticoid response between our murine model and previable human fetal tissue not exposed to steroids.…”

Section: Commentmentioning

confidence: 99%

Structural and transcriptomic response to antenatal corticosteroids in an Erk3-null mouse model of respiratory distress

Pew

Harris

Sbrana

et al. 2016

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

BACKGROUND Neonatal respiratory distress syndrome in preterm infants is a leading cause of neonatal death. Pulmonary insufficiency-related infant mortality rates have improved with antenatal glucocorticoid treatment and neonatal surfactant replacement. However, the mechanism of glucocorticoid-promoted fetal lung maturation is not understood fully, despite decades of clinical use. We previously have shown that genetic deletion of Erk3 in mice results in growth restriction, cyanosis, and early neonatal lethality because of pulmonary immaturity and respiratory distress. Recently, we demonstrated that the addition of postnatal surfactant administration to antenatal dexamethasone treatment resulted in enhanced survival of neonatal Erk3-null mice. OBJECTIVE To better understand the molecular underpinnings of corticosteroid-mediated lung maturation, we used high-throughput transcriptomic and high-resolution morphologic analysis of the murine fetal lung. We sought to examine the alterations in fetal lung structure and function that are associated with neonatal respiratory distress and antenatal glucocorticoid treatment. STUDY DESIGN Dexamethasone (0.4 mg/kg) or saline solution was administered to pregnant dams on embryonic days 16.5 and 17.5. Fetal lungs were collected and analyzed by microCT and RNA-seq for differential gene expression and pathway interactions with genotype and treatment. Results from transcriptomic analysis guided further investigation of candidate genes with the use of immunostaining in murine and human fetal lung tissue. RESULTS Erk3−/− mice exhibited atelectasis with decreased overall porosity and saccular space relative to wild type, which was ameliorated by glucocorticoid treatment. Of 596 differentially expressed genes (q < 0.05) that were detected by RNA-seq, pathway analysis revealed 36 genes (q < 0.05) interacting with dexamethasone, several with roles in lung development, which included corticotropin-releasing hormone and surfactant protein B. Corticotropin-releasing hormone protein was detected in wild-type and Erk3−/− lungs at E14.5, with significantly temporally altered expression through embryonic day 18.5. Antenatal dexamethasone attenuated corticotropin-releasing hormone at embryonic day 18.5 in both wild-type and Erk3−/− lungs (0.56-fold and 0.67-fold; P < .001). Wild type mice responded to glucocorticoid administration with increased pulmonary surfactant protein B (P = .003). In contrast, dexamethasone treatment in Erk3−/− mice resulted in decreased surfactant protein B (P = .012). In human validation studies, we confirmed that corticotropin-releasing hormone protein is present in the fetal lung at 18 weeks of gestation and increases in expression with progression towards viability (22 weeks of gestation; P < .01). CONCLUSION Characterization of whole transcriptome gene expression revealed glucocorticoid-mediated regulation of corticotropin-releasing hormone and surfactant protein B via Erk3-independent and -dependent mechanisms, respectively. We demonstrated for the first t...

show abstract

Effectiveness of antenatal steroids in obstetric subgroups

Cited by 70 publications

References 16 publications

A comparison of the effectiveness of single-dose vs multi-dose antenatal corticosteroids in pre-term neonates

A comparison of the effectiveness of single-dose vs multi-dose antenatal corticosteroids in pre-term neonates

Association of Antenatal Corticosteroids With Mortality, Morbidity, and Neurodevelopmental Outcomes in Extremely Preterm Multiple Gestation Infants

Structural and transcriptomic response to antenatal corticosteroids in an Erk3-null mouse model of respiratory distress

Contact Info

Product

Resources

About