Evaluation of the effectiveness of antenatal corticoid in preterm twin and single pregnancies: a multicenter cohort study.

Autor:	Assad Gonçalves-Ferri W; Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, State of São Paulo, Brazil., Martinez FE; Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, State of São Paulo, Brazil., Martins-Celini FP; Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, State of São Paulo, Brazil., de Almeida JHCL; Department of Pediatrics, Oswaldo Cruz Foundation, Fernandes Figueira Institute, Rio de Janeiro, State of Rio de Janeiro, Brazil., Procianoy R; Department of Pediatrics, Federal University of Rio Grande do Sul, Porto Alegre Clinic Hospital, Porto Alegre, State of Rio Grande do Sul, Brazil., Duarte JLMB; Department of Pediatrics, Universitary Hospital Pedro, Rio de Janeiro State University, Rio de Janeiro, State of Rio de Janeiro, Brazil., Carvalho EAA; Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, State of Minas Gerais, Brazil., de Lima Mota Ferreira DM; Department of Pediatrics, Federal University of Uberlandia, Uberlandia, State of Minas Gerais, Brazil., Alves Filho N; Department of Pediatrics, Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, State of Minas Gerais, Brazil., Santos JP; Department of Pediatrics, Sumare State Hospital, State University of Campinas, Campinas, State of São Paulo, Brazil., Gimenez CB; Pirajussara State Hospital, Department of Pediatrics, Federal University of São Paulo, São Paulo, State of São Paulo, Brazil., do Santos CN; State Hospital Diadema, Neonatal Unit, São Paulo Federal University, São Paulo, State of São Paulo, Brazil., Ferrari LSL; Department of Pediatrics, Londrina State University Health Sciences Center, Londrina, State of Paraná, Brazil., Venzon PS; Department of Pediatrics, Federal University of Parana, Curitiba, State of Paraná, Brazil., Meneses J; Department of Pediatrics, Professor Fernando Figueira Institute of Integral Medicine, Recife, State of Pernambuco, Brazil., do Vale MS; Department of Pediatrics, University Hospital of the Federal University of Maranhão, São Luiz, State of Maranhão, Brazil., de Souza Rugolo LMS; Department of Pediatrics, Botucatu Medical School- São Paulo State University Julio de Mesquita Neto, Botucatu, State of São Paulo, Brazil., de Almeida MFB; Department of Pediatrics, Federal University of São Paulo, São Paulo, State of São Paulo, Brazil., Krebs VLJ; Department of Pediatrics, Children's Institute, São Paulo Medical School, University of São Paulo, São Paulo, State of São Paulo, Brazil., de Albuquerque Diniz EM; Department of Pediatrics, University Hospital, São Paulo Medical School, University of São Paulo, São Paulo, State of São Paulo, Brazil., Fiori HH; Department of Pediatrics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, State of Rio Grande do Sul, Brazil., Marba STM; Department of Pediatrics, Campinas State University, Campinas, State São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	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 [J Matern Fetal Neonatal Med] 2022 Sep; Vol. 35 (18), pp. 3502-3508. Date of Electronic Publication: 2021 Jun 22.
DOI:	10.1080/14767058.2020.1822806
Abstrakt:	Background: The effects of antenatal corticosteroids (ANSs) on twins are not well established. Objective: To determine the impact of ANS use according to the number of fetuses. Methods: Retrospective cohort study of newborns between 23 and 33 weeks of gestational age, birth weight from 400 to 1499 g, without malformations, delivered at 20 public university hospitals from 2010 to 2014.Exposed group: Received ANS (any time, any dose) and no exposed group: no received ANS. Analysis of birth conditions and clinical outcomes. Association of variables, relative risks, and 95% confidence intervals estimated from the adjustment of log-binomial regression models. Results: About 7165 premature infants were analyzed: 5167 singleton, 937 twins, and 104 triplets. Characteristics of gestations with one, two, or three fetuses not receiving ANS were similar. Reduced hemodynamic instability in single and twins gestations in the first 72 h were observed (Adj R 2 Twins = 0.78; 95% CI = 0.69-0.86) (Adj R 2 Singles = 0.79; 95% CI = 0.62-0.99). Reduced peri-intraventricular hemorrhage (Adj R 2 Twins = 0.54; 95% CI = 0.36-0.78) (Adj R 2 singles = 0.54; 95% CI = 0.36-0.78); and early sepsis reduction on single and triplex gestations (Adj R 2 triplex = 0.51; 95% CI = 0.27-0.94) (Adj single R 2 = 0.51; 95% CI = 0.27-0.94) were observed. Conclusions: This study demonstrates ANS produces an important protective factor for severe intraventricular hemorrhage and hemodynamic instability in single and multiple pregnancies. ANS had a protective effect on death and birth conditions improvement just in single gestations. Regarding respiratory aspects was not observed the protective effect in the single or multiple gestations.
Databáze:	MEDLINE
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