The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2017
Effect of antenatal corticosteroids on morbidity and mortality of preterm singletons and twins.
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Vaz Ana, Malheiro Maria Filipa, Severo Milton, Rodrigues Teresa, Guimarães Hercília, Montenegro Nuno
Аннотация
PURPOSE: To compare the effect of antenatal corticosteroids (ACS) on neonatal outcomes among singleton and twin pregnancies and the impact of completeness and timing of ministration.
MATERIALS AND METHODS: Retrospective cohort study involving 951 preterm deliveries (25+0-34+6 weeks), between 2006 and 2015. Neonatal outcomes were evaluated according to completeness of ACS ("Complete" n = 441; "Rescue" n = 38; "Incomplete" n = 175; "No ACS" n = 98) and timing of therapy related to delivery ("Before 7 days" n = 260; "After 7 days" n = 181).
RESULTS: On respiratory distress syndrome (RDS), odds ratio (OR) for twins was 0.172, 95% confidence interval (CI) was 0.047; 0.591 and for singletons 0.390 (95%CI 0.214; 0.703) for complete or rescue courses, and 0.280 (95%CI 0.069; 1.066) for twins and 0.906 (95%CI 0.482; 1.698) for singletons for incomplete courses. About the need for mechanical ventilation (MV), twins had an OR of 0.189 (95%CI 0.052; 0.642) and singletons of 0.404 (95%CI 0.222; 0.727) for complete or rescue courses and twins had OR = 0.225 (95%CI 0.053; 0.874) and singletons of 0.404 (95%CI 0.222; 0.727) for incomplete courses. About timing, group "After 7 days" had OR = 2.00 for RDS (95%CI 1.21; 3.30) and 2.32 (95%CI 1.42; 3.78) for MV.
CONCLUSIONS: ACS improves neonatal outcomes both in singleton and twins. Delivering 7 days after a complete course decreased neonatal morbidity.
MATERIALS AND METHODS: Retrospective cohort study involving 951 preterm deliveries (25+0-34+6 weeks), between 2006 and 2015. Neonatal outcomes were evaluated according to completeness of ACS ("Complete" n = 441; "Rescue" n = 38; "Incomplete" n = 175; "No ACS" n = 98) and timing of therapy related to delivery ("Before 7 days" n = 260; "After 7 days" n = 181).
RESULTS: On respiratory distress syndrome (RDS), odds ratio (OR) for twins was 0.172, 95% confidence interval (CI) was 0.047; 0.591 and for singletons 0.390 (95%CI 0.214; 0.703) for complete or rescue courses, and 0.280 (95%CI 0.069; 1.066) for twins and 0.906 (95%CI 0.482; 1.698) for singletons for incomplete courses. About the need for mechanical ventilation (MV), twins had an OR of 0.189 (95%CI 0.052; 0.642) and singletons of 0.404 (95%CI 0.222; 0.727) for complete or rescue courses and twins had OR = 0.225 (95%CI 0.053; 0.874) and singletons of 0.404 (95%CI 0.222; 0.727) for incomplete courses. About timing, group "After 7 days" had OR = 2.00 for RDS (95%CI 1.21; 3.30) and 2.32 (95%CI 1.42; 3.78) for MV.
CONCLUSIONS: ACS improves neonatal outcomes both in singleton and twins. Delivering 7 days after a complete course decreased neonatal morbidity.
Предметные рубрики MeSH
AdultApgar ScoreBetamethasoneCase-Control StudiesDexamethasoneFemaleGestational AgeGlucocorticoidsHumansInfant, NewbornInfant, PrematureInfant, Premature, DiseasesInjections, IntramuscularIntensive Care Units, NeonatalMalePregnancyPregnancy OutcomePregnancy, TwinPremature BirthRespiration, ArtificialRetrospective StudiesTime FactorsTwins