Original ArticlesEffectiveness of antenatal steroids in obstetric subgroups
Section snippets
Materials and methods
We studied the neonatal outcomes for all women who delivered infants weighing 1750 g or less at birth between January 1990 and July 1997 at our institution. The study population was divided primarily into three clinical groups: preterm labor with intact membranes, PROM, and pregnancy-associated hypertension. Secondarily, the total population was divided based on birth weight and gestational age into AGA and fetal growth-restricted (FGR) neonates.
Preterm labor with intact membranes was diagnosed
Results
A total of 1148 neonates weighing 1750 g or less were delivered during the study period. Four hundred forty-seven and 410 neonates were delivered after preterm labor with intact membranes and PROM, respectively. Two hundred forty-five neonates were born to mothers with pregnancy-associated hypertension, and the remaining 46 were delivered for other maternal indications. Nine hundred twenty-eight neonates were AGA, and the remaining 220 were growth restricted. Because of the small number of
Discussion
Preterm delivery occurs in 7–10% of all pregnancies and is the single major cause of infant morbidity and mortality. Premature neonates suffer a multitude of complications, including RDS, intraventricular hemorrhage and periventricular leukomalacia, necrotizing enterocolitis, sepsis, and retinopathy of prematurity, all of which require substantial health care efforts and expense. Additionally, 20% of such infants suffer major sequelae requiring repeat hospitalizations and special services.
It is
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Sex differences in modulation of fetoplacental vascular resistance in growth-restricted mouse fetuses following betamethasone administration: comparisons with human fetuses
2021, American Journal of Obstetrics and Gynecology MFMCitation Excerpt :There has not been a randomized controlled trial to assess the effect of corticosteroids on the FGR population, and the clinical findings to date are conflicting.3–5 Although some studies in FGR pregnancies have reported improved birth outcomes after corticosteroids,6–8 several have found that administration of corticosteroids may not confer any additional benefit9–12 because the metabolic stress resulting from the intervention may be deleterious. The effect of corticosteroids on the fetoplacental hemodynamics also differs between healthy and growth-restricted fetuses.
Antenatal corticosteroids in preterm small-for-gestational age infants: a systematic review and meta-analysis
2020, American Journal of Obstetrics and Gynecology MFMAntenatal glucocorticoids, magnesium sulfate, and mode of birth in preterm fetal small for gestational age
2018, American Journal of Obstetrics and GynecologyCitation Excerpt :A follow-up study of SGA neonates born between 26-32 weeks’ gestation suggested that survival without disability or handicap at 2 years’ corrected age was increased in children who received betamethasone as fetuses, compared with children who did not receive betamethasone, although there was a statistically significant negative effect of betamethasone on subsequent somatic growth45 (Table). In contrast, some studies reported no effects of antenatal corticosteroids on neonatal morbidity or mortality among SGA infants.46-49 van Stralen et al,46 in a retrospective cohort study, reported that the prevalence of adverse neonatal outcomes did not differ between severely preterm SGA fetuses with and without exposure to antenatal corticosteroids.
The role of antenatal corticosteroids in twin pregnancies complicated by preterm birth
2016, American Journal of Obstetrics and GynecologyCitation Excerpt :This retrospective cohort study included all singleton and twin live-born neonates born between 240/7 and 336/7 weeks of gestation and admitted to level III neonatal intensive care units participating in the Canadian Neonatal Network between January 2010 and December 2014. Exclusion criteria included birthweight less than the third percentile (because fetal growth restriction has been shown to affect the impact of antenatal corticosteroids42,45-52), clinical chorioamnionitis, major congenital anomalies, incomplete information on the administration of antenatal corticosteroids, administration of more than 1 course of antenatal corticosteroids, administration of a partial course of antenatal corticosteroids, or administration of antenatal corticosteroids <24 hours or >7 days before birth. The Canadian Neonatal Network maintains a national database of outcomes, risk factors, and practices for infants admitted to level III neonatal intensive care units in Canada.
Structural and transcriptomic response to antenatal corticosteroids in an Erk3-null mouse model of respiratory distress
2016, American Journal of Obstetrics and GynecologyCitation Excerpt :Potential limitations to our study include the presentation of IUGR in homozygous Erk3 knockout pups.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.
Risk factors of late-onset neonatal sepsis in Taiwan: A matched case-control study
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