Antenatal corticosteroid therapy, delivery intervals and perinatal mortality in low-resource settings.

Autor:	Mwita S; Department of Pharmaceutics and Pharmacy Practice, Catholic University of Health and Allied Sciences, Mwanza 33109, Tanzania., Kamala B; Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam 11103, Tanzania.; Department of Research, Haydom Lutheran Hospital, Haydom, Manyara 27431, Tanzania., Konje E; Department of Epidemiology and Biostatistics, Catholic University of Health and Allied Sciences, Mwanza 33109, Tanzania., Katabalo D; Department of Pharmaceutics and Pharmacy Practice, Catholic University of Health and Allied Sciences, Mwanza 33109, Tanzania., Msanga DR; Department of Pediatrics, Bugando Medical Centre, Mwanza 33109, Tanzania., Marwa KJ; Department of Pharmacology, Catholic University of Health and Allied Sciences, Mwanza 33109, Tanzania., Basinda N; Department of Community Medicine, Catholic University of Health and Allied Sciences, Mwanza 33019, Tanzania., Kongola G; Department of Pharmacology, Catholic University of Health and Allied Sciences, Mwanza 33109, Tanzania., Jande M; Department of Pharmacology, Catholic University of Health and Allied Sciences, Mwanza 33109, Tanzania., Dewey D; Owerko Centre at the Alberta Children's Hospital Research Institute and Departments of Pediatrics and Community Health Sciences and Hotchkiss Brain Institute, University of Calgary, Calgary T2N 1N4, Canada.
Jazyk:	angličtina
Zdroj:	Journal of tropical pediatrics [J Trop Pediatr] 2023 Oct 05; Vol. 69 (6).
DOI:	10.1093/tropej/fmad037
Abstrakt:	Background: Uncertainty exists regarding the ideal interval between the administration of antenatal corticosteroids (ACS) and delivery. The study's objective was to assess the risks of perinatal mortality and respiratory distress syndrome (RDS) among preterm neonates whose mothers gave birth within 48 h of the administration of ACS and those whose mothers gave birth between 48 h and 7 days. Methods: The study design was a secondary analysis of data from an observational prospective chart review study that was carried out in Tanzania in 2020. Preterm infants born to mothers who got at least one dose of ACS between 28 and 34 weeks of pregnancy were included. Results: A total of 346 preterm neonates (294 singletons and 52 twins) were exposed to ACS. Compared to infants born 48 h following the first dose of ACS, those exposed to the drug between 48 h and 7 days had significantly decreased rates of perinatal mortality and RDS. Multivariable analysis revealed that infants exposed ACS between 48 h and 7 days prior to delivery had lower risk of perinatal mortality (aRR 0.30, 95% CI 0.14-0.66) and RDS (aRR 0.27, 95% CI 0.14-0.52). Conclusion: The first dose of ACS given between 48 h and 7 days before delivery was associated with a lower risk of perinatal mortality and RDS than when the first dose was given <48 h before delivery. To improve neonatal outcomes, healthcare providers should consider administering ACS to mothers at the appropriate time. (© The Author(s) [2023]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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