Effect of antenatal corticosteroids on respiratory morbidity in singletons after late-preterm birth.

Autor: Gyamfi-Bannerman C; Department of Obstetrics and Gynecology, Columbia University, New York, New York 10032, USA., Gilbert S, Landon MB, Spong CY, Rouse DJ, Varner MW, Meis PJ, Wapner RJ, Sorokin Y, Carpenter M, Peaceman AM, O'Sullivan MJ, Sibai BM, Thorp JM, Ramin SM, Mercer BM
Jazyk: angličtina
Zdroj: Obstetrics and gynecology [Obstet Gynecol] 2012 Mar; Vol. 119 (3), pp. 555-9.
DOI: 10.1097/AOG.0b013e31824758f6
Abstrakt: Objective: To evaluate whether neonates born to women who previously had received antenatal corticosteroids and then delivered a late-preterm-birth neonate had less respiratory morbidity compared with those not exposed to antenatal corticosteroids.
Methods: This is a secondary analysis from a multicenter observational study regarding mode of delivery after previous cesarean delivery. We compared women who received one course of antenatal corticosteroids with unexposed parturients and evaluated various respiratory outcomes among those having a singleton, late-preterm-birth neonate. We controlled for potential confounders including gestational age at delivery, diabetes, mode of delivery, and maternal race.
Results: Five thousand nine hundred twenty-four patients met the inclusion criteria; 550 received steroids and 5,374 did not. In the univariable model, compared with unexposed women, those who received antenatal corticosteroids appeared more likely to have neonates who required ventilatory support (11.5% compared with 8.6%, P=.022), had respiratory distress syndrome (RDS) (17.1% compared with 12.2%, P=.001), developed transient tachypnea of the newborn (12.9% compared with 9.8%, P=.020), or required resuscitation in the delivery room (55.8% compared with 49.7%, P=.007). After controlling for confounding factors, we found no significant differences among the groups regarding all of the above outcomes with an odds ratio for RDS of 0.78 (95% confidence interval, 0.60-1.02) and ventilator support of 0.75 (95% confidence interval, 0.55-1.03).
Conclusion: Exposure to antenatal corticosteroids does not significantly affect respiratory outcomes among those with a subsequent late-preterm birth.
Databáze: MEDLINE