457: Does prepregnancy weight or maternal BMI at betamethasone administration impact late preterm respiratory morbidity?

Abstract Objective We sought to determine if maternal prepregnancy body mass index (BMI) is a risk factor for neonatal respiratory morbidity and to determine if increasing BMI decreased the efficacy of betamethasone (BMZ). Study Design This was a secondary analysis of the Antenatal Late Preterm Steroids trial, double-blind, randomized controlled trial involving 2,831 women between 340/7 and 365/7 weeks who received BMZ or a matching placebo. We compared the rate of neonatal respiratory morbidity among prepregnancy BMI classes in both the placebo and treatment groups. We also stratified the treatment effect by maternal BMI at the time of delivery. Results A total of 2,822 women were identified with maternal weight recorded at delivery; 2,740 women also had self-reported prepregnancy weight available. When stratified by prepregnancy BMI class, there was no difference in neonatal respiratory morbidity in the BMZ or in placebo groups. When analyzed by BMI at delivery, there was no difference in the rate of neonatal respiratory morbidity, and BMI was not a predictor of treatment response (odds ratio = 1.00, 95% confidence interval = 0.99–1.02). Conclusion Maternal prepregnancy BMI is not associated with late preterm neonatal respiratory morbidity. Maternal obesity does not decrease the efficacy of BMZ for preventing late preterm neonatal respiratory morbidity.

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Comparison of Respiratory Morbidity in Late Preterm and Term Infants at a Single Institution

Soonchunhyang Medical Science ◽

10.15746/sms.12.017 ◽

2014 ◽

Vol 18 (2) ◽

pp. 85-90

Author(s):

Won Hee Choi ◽

Eun-Kyeong Yeon ◽

Young-Lim Shin ◽

Won Suk Suh ◽

Jang Yong Jin

Keyword(s):

Late Preterm ◽

Respiratory Morbidity ◽

Single Institution ◽

Term Infants

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Respiratory Morbidity in Late-Preterm Infants: Prevention Is Better Than Cure!

American Journal of Perinatology ◽

10.1055/s-2007-1022471 ◽

2008 ◽

Vol 25 (2) ◽

pp. 075-078 ◽

Cited By ~ 27

Author(s):

Lucky Jain

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Respiratory Morbidity ◽

Late Preterm Infants ◽

Better Than

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Neonatal respiratory morbidity in late-preterm births in pregnancies with and without gestational diabetes mellitus

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.3109/14767058.2016.1174208 ◽

2016 ◽

Vol 30 (4) ◽

pp. 377-379 ◽

Cited By ~ 3

Author(s):

Katja Bricelj ◽

Natasa Tul ◽

Miha Lucovnik ◽

Lilijana Kronhauser-Cerar ◽

Lili Steblovnik ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Preterm Births ◽

Late Preterm ◽

Respiratory Morbidity

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A randomized controlled trial of restricted versus standard fluid management in late preterm and term infants with transient tachypnea of the newborn

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-190400 ◽

2020 ◽

Vol 13 (4) ◽

pp. 477-487

Author(s):

S. Sardar ◽

S. Pal ◽

R. Mishra

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Initial Period ◽

Fluid Management ◽

Late Preterm ◽

Respiratory Morbidity ◽

Term Infants ◽

Randomized Controlled ◽

Antenatal Steroid ◽

Preterm Babies

BACKGROUND: Transient tachypnea of the newborn(TTNB) is the most common respiratory morbidity in late preterm and term babies and is pathophysiologically related to delayed lung fluid clearance after birth. Mimicking low physiological fluid intake in the initial period of life may accelerate the recovery from TTNB. In a randomized controlled trial, we compared the roles of restricted versus standard fluid management in babies with TTNB requiring respiratory support. METHODS: This parallel group,non-blinded, stratified randomized controlled trial was conducted in a level III neonatal unit of eastern India. Late preterm and term babies with TTNB requiring continuous positive airway pressure (CPAP) were randomly allocated to standard and restricted fluid arms for the first 72 hours (hrs). Primary outcome was CPAP duration. RESULTS: In total, 100 babies were enrolled in this study with 50 babies in each arm. CPAP duration was significantly less in the restricted arm (48[42, 54] hrs vs 54[48,72] hrs, p = 0.002). However, no difference was observed in the incidence of CPAP failure between the two arms. In the subgroup analysis, the benefit of reduced CPAP duration persisted in late preterm but not in term infants. However, the effect was not significant in the late preterm babies exposed to antenatal steroid. CONCLUSION: This trial demonstrated the safety and effectiveness of restrictive fluid strategy in reducing CPAP duration in late preterm and term babies with TTNB. Late preterm babies, especially those not exposed to antenatal steroid were the most benefitted by this strategy.

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Respiratory morbidity in late preterm twin infants

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-019-05191-z ◽

2019 ◽

Vol 300 (2) ◽

pp. 337-345 ◽

Cited By ~ 1

Author(s):

Deirdre Martinka ◽

Jon Barrett ◽

Elad Mei-dan ◽

Arthur Zaltz ◽

Nir Melamed

Keyword(s):

Late Preterm ◽

Respiratory Morbidity

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OC06.05: Neonatal respiratory morbidity in twins versus singletons after elective late-preterm cesarean section

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.9127 ◽

2011 ◽

Vol 38 (S1) ◽

pp. 12-12

Author(s):

M. Nanni ◽

T. Ghi ◽

T. Arcangeli ◽

A. M. Youssef ◽

F. De Musso ◽

...

Keyword(s):

Cesarean Section ◽

Late Preterm ◽

Respiratory Morbidity

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Evaluation of Hypoglycemia in Neonates of Women at Risk for Late Preterm Delivery: An Antenatal Late Preterm Steroids Trial Cohort Study

American Journal of Perinatology ◽

10.1055/s-0041-1729561 ◽

2021 ◽

Author(s):

Cynthia Gyamfi-Bannerman ◽

Kathleen A. Jablonski ◽

Sean C. Blackwell ◽

Alan T. N. Tita ◽

Uma M. Reddy ◽

...

Keyword(s):

At Risk ◽

Placebo Group ◽

Preterm Delivery ◽

Secondary Analysis ◽

Multicenter Trial ◽

Interquartile Range ◽

Late Preterm ◽

Respiratory Morbidity ◽

Key Points ◽

Lost To Follow Up

Objective In the antenatal late preterm steroids (ALPS) trial betamethasone significantly decreased short-term neonatal respiratory morbidity but increased the risk of neonatal hypoglycemia, diagnosed only categorically (<40 mg/dL). We sought to better characterize the nature, duration, and treatment for hypoglycemia. Study Design Secondary analysis of infants from ALPS, a multicenter trial randomizing women at risk for late preterm delivery to betamethasone or placebo. This study was a reabstraction of all available charts from the parent trial, all of which were requested. Unreviewed charts included those lost to follow-up or from sites not participating in the reabstraction. Duration of hypoglycemia (<40 mg/dL), lowest value and treatment, if any, were assessed by group. Measures of association and regression models were used where appropriate. Results Of 2,831 randomized, 2,609 (92.2%) were included. There were 387 (29.3%) and 223 (17.3%) with hypoglycemia in the betamethasone and placebo groups, respectively (relative risk [RR]: 1.69, 95% confidence interval [CI]: 1.46–1.96). Hypoglycemia generally occurred in the first 24 hours in both groups: 374/385 (97.1%) in the betamethasone group and 214/222 (96.4%) in the placebo group (p = 0.63). Of 387 neonates with hypoglycemia in the betamethasone group, 132 (34.1%) received treatment, while 73/223 (32.7%) received treatment in placebo group (p = 0.73). The lowest recorded blood sugar was similar between groups. Most hypoglycemia resolved by 24 hours in both (93.0 vs. 89.3% in the betamethasone and placebo groups, respectively, p = 0.18). Among infants with hypoglycemia in the first 24 hours, the time to resolution was shorter in the betamethasone group (2.80 [interquartile range: 2.03–7.03) vs. 3.74 (interquartile range: 2.15–15.08) hours; p = 0.002]. Persistence for >72 hours was rare and similar in both groups, nine (2.4%, betamethasone) and four (1.9%, placebo, p = 0.18). Conclusion In this cohort, hypoglycemia was transient and most received no treatment, with a quicker resolution in the betamethasone group. Prolonged hypoglycemia was uncommon irrespective of steroid exposure. Key Points

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