Projected benefits of universal or scheduled antepartum corticosteroids to prevent neonatal morbidity: a decision analysis
| Autor: | Valerie M. Parisi, Kim A. Boggess, Mendel E. Singer, Brian M. Mercer, Jennifer L. Bailit |
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| Rok vydání: | 2004 |
| Předmět: |
Pediatrics
medicine.medical_specialty Preterm labor symptoms medicine.drug_class Sensitivity and Specificity Infant Newborn Diseases Decision Support Techniques Adrenal Cortex Hormones Pregnancy Risk Factors medicine Humans Preterm delivery Respiratory distress business.industry Mortality rate Respiratory disease Infant Newborn Obstetrics and Gynecology medicine.disease Markov Chains Neonatal morbidity Corticosteroid Female business Decision analysis |
| Zdroj: | American journal of obstetrics and gynecology. 193(4) |
| ISSN: | 1097-6868 |
| Popis: | Objective The purpose of this study was to compare strategies of corticosteroid administration for the prevention of neonatal morbidity and death. Study design A Markov decision model compared 3 strategies of antepartum corticosteroid administration: (1) to all pregnant women (universal), (2) to all pregnant women with a previous preterm delivery (high risk), and (3) to women who had preterm labor symptoms that placed them at risk for delivery within 7 days (current). A second model with addition of a “rescue” arm to capture women who remained undelivered was also created. Results Compared with the current strategy, the universal strategy would result in roughly 1000 fewer cases of respiratory distress syndrome and >3 million more women would receive corticosteroids annually. The addition of a rescue arm further reduces morbidity and mortality rates. Conclusion A universal strategy of corticosteroid administration confers potential benefit for the prevention neonatal morbidity or death over the current strategy but requires that a large number of women be treated. |
| Databáze: | OpenAIRE |
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