Thyrotropin-releasing hormone added to corticosteroids for women at risk of preterm birth for preventing neonatal respiratory disease

Crowther, Caroline A; Alfirević, Z̄arko; Han, Shanshan; Haslam, Ross

doi:10.1002/14651858.cd000019.pub2

Cited by 30 publications

(9 citation statements)

References 32 publications

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“…Following advice of the obstetric consultants, two indicators were removed: the proportion of women with singleton pregnancies at risk of preterm delivery to be treated with a combination of corticosteroids with thyrotropin-releasing hormone [33], and the proportion of breech deliveries carried out by caesarean section [32]. The main reasons for excluding these indicators were: the first is an intervention no longer used in clinical practice, and the existing evidence on the second is controversial in nature.…”

Section: Resultsmentioning

confidence: 99%

Development of quality of care indicators from systematic reviews: the case of hospital delivery

et al. 2013

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BackgroundThe objective of this research is to generate quality of care indicators from systematic reviews to assess the appropriateness of obstetric care in hospitals.MethodsA search for systematic reviews about hospital obstetric interventions, conducted in The Cochrane Library, clinical evidence and practice guidelines, identified 303 reviews. We selected 48 high-quality evidence reviews, which resulted in strong clinical recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The 255 remaining reviews were excluded, mainly due to a lack of strong evidence provided by the studies reviewed.ResultsA total of 18 indicators were formulated from these clinical recommendations, on antepartum care (8), care during delivery and postpartum (9), and incomplete miscarriage (1). Authors of the systematic reviews and specialists in obstetrics were consulted to refine the formulation of indicators.ConclusionsHigh-quality systematic reviews, whose conclusions clearly claim in favour or against an intervention, can be a source for generating quality indicators of delivery care. To make indicators coherent, the nuances of clinical practice should be considered. Any attempt made to evaluate the extent to which delivery care in hospitals is based on scientific evidence should take the generated indicators into account.

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Section: Resultsmentioning

confidence: 99%

Development of quality of care indicators from systematic reviews: the case of hospital delivery

et al. 2013

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“…Side effects are more likely to occur in women receiving TRH. In the infants, prenatal TRH increases 16% the risk of needing ventilation, 48% having a low Apgar score at five minutes, and, for the two trials providing data, was associated with poorer outcomes at childhood follow-up (22).…”

Section: Thyrotropin-releasing Hormonementioning

confidence: 95%

“…Prenatal thyrotropin-releasing hormone (TRH), in addition to corticosteroids, given to women at risk of very PTB, does not improve infant outcomes and can cause maternal side effects (22). Overall, prenatal TRH, in addition to corticosteroids, does not reduce the risk of neonatal respiratory disease or chronic oxygen dependence, and does not improve any of the fetal, neonatal, or childhood outcomes.…”

Section: Thyrotropin-releasing Hormonementioning

confidence: 99%

Preterm labor

Berghella¹

2012

Obstetric Evidence Based Guidelines

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“…For example, preclinical research studies suggested that antenatal thyrotrophin-releasing hormone might act synergistically with corticosteroids to reduce the risk of respiratory distress syndrome in preterm infants. Despite the biological plausibility of this treatment, plus evidence of effect in animal models and encouraging findings from some trials, the Cochrane systematic review did not show any improvement in important outcomes but did find evidence of important adverse effects for mothers and infants 13. The potential for bias in the review was further reduced because the reviewers identified and included data previously reported in abstract form only and analysed data using “intention-to treat” principles.…”

Section: How Have Cochrane Reviews Influenced Practice?mentioning

confidence: 99%