Neonatal outcomes of antenatal corticosteroids in preterm multiple pregnancies compared to singletons

被引：12

作者：

Herrera, Tamara I. ^{[1
]}

Vaz Ferreira, Maria C. ^{[1
]}

Toso, Alberto ^{[2
,15
]}

Villarroel, Luis ^{[3
,30
]}

Silvera, Fernando ^{[1
]}

Ceriani-Cernadas, Jose M. ^{[4
]}

Tapia, Jose L. ^{[2
,15
,30
]}

Pedraza, Ana ^{[5
]}

Colantonio, Guillermo ^{[5
]}

Perez, Gaston ^{[5
]}

Zapata, Jorge ^{[5
]}

Tomas, Fortunato ^{[5
]}

Fustinana, Carlos ^{[6
,12
]}

Fernandez, Silvia ^{[6
]}

Mariani, Gonzalo ^{[6
]}

Paola Carrascal, Maria ^{[6
]}

Galleti, Fernanda ^{[6
]}

Tavosnaska, Jorge ^{[7
]}

Roldan, Liliana ^{[7
]}

Saa, Gladys ^{[7
]}

Sabatelli, Debora ^{[7
]}

Laura Gendra, Maria ^{[7
]}

Teresa Sepulveda, Maria ^{[7
]}

Fernanda Buraschi, Maria ^{[7
]}

Basso, Graciela ^{[7
]}

Rinaldi, Monica ^{[8
]}

Agost, Daniel ^{[8
]}

Solana, Claudio ^{[9
]}

Rojas, Elio ^{[9
]}

Nieto, Ricardo ^{[9
]}

Meritano, Javier ^{[9
]}

Vain, Nestor ^{[10
]}

Cracco, Lionel ^{[10
]}

Martinez, Edith ^{[10
]}

Jacobi, Noemi ^{[10
]}

San Miguel, Maria ^{[10
]}

Roge, Horacio ^{[11
]}

Abdala, Daniel ^{[11
]}

Guida, Martin ^{[11
]}

Pretz, Damian ^{[11
]}

Musante, Gabriel ^{[12
]}

Keller, Rodolfo ^{[12
]}

Capelli, Carola

Elizalde, Magdalena ^{[12
,25
]}

Leyla, Ana ^{[12
]}

Acha, Romina ^{[12
]}

Ahumada, Luis ^{[13
]}

Ferreyra, Mirta ^{[13
]}

Sanchez, Laura ^{[13
]}

Mitrano, Adriana ^{[13
]}

机构：

[1] Univ Republica, Ctr Hosp Pereira Rossell, Dept Neonatol, Bulevar Gen Artigas 1550, Montevideo, Uruguay

[2] Pontificia Univ Catolica Chile, Fac Med, Dept Neonatol, Santiago, Chile

[3] Pontificia Univ Catolica Chile, Fac Med, Dept Salud Publ, Santiago, Chile

[4] Hosp Italiano Buenos Aires, Dept Neonatol, Buenos Aires, DF, Argentina

[5] Clin & Maternidad Suizo Argentina, Buenos Aires, DF, Argentina

[6] Hosp Italiano Buenos Aires, Buenos Aires, DF, Argentina

[7] Hosp Juan Fernandez, Buenos Aires, DF, Argentina

[8] Hosp Lagomaggiore, Mendoza, Argentina

[9] Maternidad Sarda, Buenos Aires, DF, Argentina

[10] Sanat Trinidad, Buenos Aires, DF, Argentina

[11] Hosp Espanol Mendoza, Mendoza, Argentina

[12] Hosp Univ Austral, Buenos Aires, DF, Argentina

[13] Hosp Nuestra Senora Misericordia, Cordoba, Argentina

[14] Hosp Univ UFMA, Sao Luis, Brazil

[15] Hosp Clin Univ Catolica Chile, Santiago, Chile

[16] Hosp Clin Univ Chile, Santiago, Chile

[17] Hosp Guillermo Grant, Concepcion, Chile

[18] Hosp Gustavo Fricke, Villa Del Mar, Chile

[19] Hosp San Jose, Santiago, Chile

[20] Hosp Dr Sotero del Rio, Santiago, Chile

[21] Hosp San Borja Arriaran, Santiago, Chile

[22] Hosp Puerto Montt, Puerto Montt, Chile

[23] Hosp Van Buren, Valparaiso, Chile

[24] Hosp Antofagasta, Antofagasta, Chile

[25] Dept Hosp Clin Asuncion, Asuncion, Paraguay

[26] Hosp San Pablo, Asuncion, Paraguay

[27] Hosp Cayetano Heredia, Lima, Peru

[28] Hosp Guillermo Almenara, Lima, Peru

[29] Serv Recien Nacidos Pereira Rossell, Fac Med, Montevideo, Uruguay

[30] Pontificia Univ Catolica, Unidad Base Datos, Santiago, Chile

来源：

EARLY HUMAN DEVELOPMENT | 2019年 / 130卷

关键词：

Antenatal steroids; Preterm multiple pregnancies; Neonatal outcomes; RESPIRATORY-DISTRESS-SYNDROME; BIRTH-WEIGHT INFANTS; NEURODEVELOPMENTAL OUTCOMES; TWIN PREGNANCIES; BETAMETHASONE; MORTALITY; MORBIDITY; PREVENTION; TRIPLETS; EXPOSURE;

D O I：

10.1016/j.earlhumdev.2019.01.008

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Background: Antenatal corticosteroids (ACS) during preterm labour reduce neonatal mortality and morbidity. Evidence on preterm multiple pregnancies is limited and contradictory. Objective: Compare the effect of ACS on very low birth weight infant's (VLBW) mortality and morbidity among singleton and multiple pregnancies. Study design: Retrospective cohort study, employing prospectively collected data, of infants 23 to 34 weeks' gestation and 500 to 1500 g born at the Neocosur Neonatal Network centers during 2007-2016. Neonatal outcomes were compared among singleton and multiple pregnancies exposed to at least one dose of ACS to those not exposed using logistic regression analyses controlled for birthweight, gestational age, sex, small for gestational age (SGA) and mode of delivery. Results: A total of 13,864 infants were studied; 2948 multiple (21.3%) and 10,904 singleton pregnancies (78.7%). Overall, 11,218 (81.4%) received at least one dose of ACS with a significant reduction in the risk of death, RDS and grade III or IV IVH compared to those not exposed. Both singleton and multiple pregnancies exposed to ACS showed similar reduced risk of death (aRR 0.41 [95% CI, 0.36-0.47] vs. aRR 0.46 [95% CI, 0.34-0.64]). However, ACS were not associated with reduced odds of RDS (aRR 0.89 [95% CI, 0.66-1.23]) or grade III or IV IVH (aRR 0.99 [95% CI, 0.67-1.48]) in multiple pregnancies. Conclusion: The benefit of administration of at least one dose of ACS in VLBW multiple and singleton pregnancies is comparable in terms of death. However, ACS showed no relevant impact in short-term morbidity in multiple pregnancies.

引用

页码：44 / 50

页数：7

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