Timing of antenatal corticosteroid administration and survival in extremely preterm infants: a national population‐based cohort study

Norberg, Hanna; Kowalski, Jan; Maršál, Karel; Norman, Mikael

doi:10.1111/1471-0528.14545

Cited by 53 publications

(38 citation statements)

References 42 publications

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“…The study confirmed previous findings of an increased rate of neonatal respiratory complications and an increased number of days in the NICU when the ACS delivery interval was more than seven days after adjusting for major confounders such as gestational age and the obstetric indication for treatment (4,14). Previous studies have adjusted for an incomplete set of obstetric indications, such as PPROM and preeclampsia (4,8,14,15). To our knowledge this is the first study adjusting for obstetric indications in a systematic way when analyzing the associations between the timing of ACS and the neonatal oucome.…”

Section: Discussionsupporting

confidence: 88%

Antenatal corticosteroids: a retrospective cohort study on timing, indications and neonatal outcome

Frändberg

Sandblom

Bruschettini

et al. 2018

Acta Obstet Gynecol Scand

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Optimal timing of ACS treatment varied significantly based on the clinical indication. Women with preterm prelabor rupture of membranes or vaginal bleeding were more likely to have an ACS delivery interval of more than seven days. A prolonged ACS delivery interval was associated with an increased risk of neonatal respiratory morbidity and a prolonged stay in the neonatal care unit, but not with neonatal mortality.

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Section: Discussionsupporting

confidence: 88%

Antenatal corticosteroids: a retrospective cohort study on timing, indications and neonatal outcome

Frändberg

Sandblom

Bruschettini

et al. 2018

Acta Obstet Gynecol Scand

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“…Although the majority of the mothers in both groups received AST prior to delivery, a high proportion of the PE mothers received AST in close proximity to delivery in our study. The optimal timing of AST, i.e., when administered 1-7 days prior to delivery, has the most beneficial effect on fetal outcome [17]. Absence of data on the time point of AST in the control mothers is an obvious limitation.…”

Section: Discussionmentioning

confidence: 99%

Reduced Prevalence of Severe Intraventricular Hemorrhage in Very Preterm Infants Delivered after Maternal Preeclampsia

2018

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Background: Very preterm (VPT) delivery after severe preeclampsia (PE) has been associated with adverse perinatal outcome. It is unclear whether fetal exposure to PE per se modifies the prevalence of neonatal morbidities associated with VPT birth. Objectives: To evaluate neonatal morbidity in VPT infants exposed to maternal PE compared to morbidity in nonexposed VPT infants. Methods: This retrospective study consisted of all inborn infants delivered before 30 gestational weeks admitted to a tertiary-level neonatal intensive care unit between 1998 and 2014: 195 infants exposed to maternal PE were compared to 957 infants without maternal PE (background group). Prevalence rates of neonatal morbidity, cerebral palsy (CP), and mortality at 2 years of age were obtained from patient records. Results: The PE group had a lower median (IQR) birth weight (795 [262] g) and a higher median gestational age (GA) (27 [3] weeks) at birth than the background group (890 [385] g and 26 [3] weeks, respectively; both p < 0.001). Exposure to maternal PE was associated with lower rates of severe intraventricular hemorrhage (IVH) (2 vs. 11%), retinopathy of prematurity requiring treatment (2 vs. 7%), mortality (9 vs. 15%), and CP (4 vs. 8%). Exposure to PE remained associated with a reduced prevalence of severe IVH (OR 0.17, 95% CI 0.05–0.57) after adjustment for GA, multiple birth, Apgar score, delivery mode, sex, and antenatal steroid treatment. Conclusion: Fetal exposure to PE is associated with a decreased rate of severe IVH following VPT birth. Studies on underlying mechanisms may provide a basis for prevention of IVH in the VPT infant.

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“…An example of this is shown in ▶ Fig. 2, which depicts the neonatal survival of infants born preterm at ≤ 26 weeks of gestation [36].…”

Section: Timing Of Antenatal Steroid Administrationmentioning

confidence: 99%

“…23 h before birth ACS but no info on timing ACS more than 7 days before birth ACS 48 h to 7 days before birth ACS 24-47 h before birth ▶Fig. 2Survival of very immature infants (< 26th week of gestation) according to the timing of antenatal steroid administration[36].…”

mentioning

confidence: 99%

Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) – Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes

Berger

Abele

Bahlmann

et al. 2019

Geburtshilfe Frauenheilkd

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Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. Methods The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). Recommendations Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.

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Timing of antenatal corticosteroid administration and survival in extremely preterm infants: a national population‐based cohort study

Abstract: Timing of antenatal corticosteroids is important for extremely preterm infants' survival.

Cited by 53 publications

References 42 publications

Antenatal corticosteroids: a retrospective cohort study on timing, indications and neonatal outcome

Antenatal corticosteroids: a retrospective cohort study on timing, indications and neonatal outcome

Reduced Prevalence of Severe Intraventricular Hemorrhage in Very Preterm Infants Delivered after Maternal Preeclampsia

Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) – Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes

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