Is There a Benefit of Antenatal Corticosteroid When Given < 48 Hours Before Delivery?

2021 ◽  
Author(s):  
Yoav Siegler ◽  
Naphtali Justman ◽  
Gal Bachar ◽  
Roy Lauterbach ◽  
Yaniv Zipori ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Neonatal Outcome ◽  
Neonatal Morbidity ◽  
Time Interval ◽  
Outcome Study ◽  
Antenatal Corticosteroid ◽  
Time Intervals ◽  
Corticosteroid Administration ◽  
Adverse Neonatal Outcome ◽  
Adverse Neonatal Outcomes

Abstract Objective We assessed the association between a short Antenatal Corticosteroid Administration-to-Birth Interval and neonatal outcome. Study design: A retrospective study between 2010- 2020. Eligible cases were singleton preterm live-born neonates born between 24 0/7 and 33 6/7 weeks of gestation and were initiated an ACS course of Betamethasone. We divided the first 48 hours following 1st ACS administration to four-time intervals and compared each time interval to those born more than 48 hours following ACS administration. The primary outcome was a composite of adverse neonatal outcome, including neonatal mortality or any major neonatal morbidity. Results A total of 200 women gave birth less than 48 hours from receiving the first betamethasone injection, and 172 women gave birth within 2-7 days (48-168 hours) from ACS administration. Composite adverse neonatal outcome was higher for neonates born less than 12 hours from initial ACS administration compared to neonates born 2-7 days from first betamethasone injection (55.45% vs. 29.07%, OR 3.45 95% CI [2.02-5.89], p.value<0.0001). However, there was no difference in composite adverse neonatal outcomes between neonates born 12-48 hours following ACS administration and those born after 2-7 days. That was also true after adjusting for confounders. Conclusions 12-24 hours following ACS Administration may be sufficient in reducing the same risk of neonatal morbidities as > 48 hours following ACS administration. It may raise the question regarding the utility of the second dose of ACS.

scholarly journals Timing of Antenatal Corticosteroid Administration in Monoamniotic Twins

2019 ◽  
Vol 09 (02) ◽  
pp. e153-e159
Author(s):  
Carolina Bibbo ◽  
Sarah Easter ◽  
Michael Saadeh ◽  
Sarah Little ◽  
Julian Robinson
Keyword(s):  
Generalized Estimating Equations ◽  
Primary Outcome ◽  
Fetal Heart ◽  
Clinical Status ◽  
Fetal Monitoring ◽  
Optimal Timing ◽  
Antenatal Corticosteroid ◽  
Single Institution ◽  
Corticosteroid Administration ◽  
Univariate Analyses

Objective This study was aimed to determine if different strategies of antenatal corticosteroid (ACS) administration in monoamniotic twins leads to receipt within 7 days of delivery. Study Design This is a retrospective cohort of monoamniotic twins managed at a single institution from 2007 to 2017. Patients were classified as to whether ACS were administered upon admission or at a predetermined gestational age (grouped together as “routine”) or for a change in clinical status (“indicated”). We used univariate analyses to associate ACS administration strategies with our primary outcome: receipt of ACS within 7 days of delivery. We then used generalized estimating equations to examine associations between fetal monitoring patterns and delivery within 1 week. Results Twenty-four patients were included: eighteen patients in the “routine” group and six patients in the “indicated” group. There was no difference in optimal timing of ACS administration. Women experiencing delivery within the week were thrice more likely to spend on average more than 3 hours/day on the fetal monitor when compared with those who remained undelivered. Conclusion Administration of ACS on admission is not effective. Fetal heart rate tracing surveillance might be a better methodology to predict delivery and guide ACS administration.

scholarly journals Electronic Fetal Monitoring and Neonatal Outcomes when a Nuchal Cord Is Present at Delivery

2019 ◽  
Vol 37 (04) ◽  
pp. 378-383
Author(s):  
Ebony B. Carter ◽  
Cheryl S. Chu ◽  
Zach Thompson ◽  
Methodius G. Tuuli ◽  
George A. Macones ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Fetal Heart ◽  
Neonatal Morbidity ◽  
Fetal Monitoring ◽  
Neonatal Outcomes ◽  
Nuchal Cord ◽  
Electronic Fetal Monitoring ◽  
Adverse Neonatal Outcomes ◽  
Morbidity Index ◽  
Singleton Pregnancies

Objective This study aimed to determine the association between nuchal cord, electronic fetal monitoring parameters, and adverse neonatal outcomes. Study Design This was a prospective cohort study of 8,580 singleton pregnancies. Electronic fetal monitoring was interpreted, and patients with a nuchal cord at delivery were compared with those without. The primary outcome was a composite neonatal morbidity index. Logistic regression was used to adjust for confounders. Result Of 8,580 patients, 2,071 (24.14%) had a nuchal cord. There was no difference in the risk of neonatal composite morbidity in patients with or without a nuchal cord (8.69 vs. 8.86%; p = 0.81). Nuchal cord was associated with category II fetal heart tracing and operative vaginal delivery (OVD) (6.4 vs. 4.3%; p < 0.01). Conclusion Nuchal cord is associated with category II electronic fetal monitoring parameters, which may drive increased rates of OVD. However, there is no significant association with neonatal morbidity.

Relationship between the time interval from antenatal corticosteroid administration until preterm birth and the occurrence of respiratory morbidity

2011 ◽  
Vol 205 (1) ◽  
pp. 49.e1-49.e7 ◽  
Author(s):  
Femke F. Wilms ◽  
Jolande Y. Vis ◽  
Desiree A.P.M. Pattinaja ◽  
Rosanna A. Kuin ◽  
Monique C. Stam ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Respiratory Morbidity ◽  
Time Interval ◽  
Antenatal Corticosteroid ◽  
Corticosteroid Administration

The effects of the time interval from antenatal corticosteroid exposure to delivery on neonatal outcome of very low birth weight infants

2004 ◽  
Vol 191 (4) ◽  
pp. 1409-1413 ◽  
Author(s):  
Harish M. Sehdev ◽  
Soraya Abbasi ◽  
Patricia Robertson ◽  
Lytia Fisher ◽  
Dominic A. Marchiano ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Neonatal Outcome ◽  
Time Interval ◽  
Antenatal Corticosteroid ◽  
Low Birth Weight Infants

Maternal and fetal factors contributing to neonatal outcome in Al-Tibri Medical College and Hospital

2021 ◽  
Vol 15 (1) ◽  
pp. 18-22
Author(s):  
Erum Saboohi ◽  
Nighat Seema ◽  
Abdulah Hadi Hassan
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Preterm Delivery ◽  
Neonatal Outcome ◽  
Neonatal Outcomes ◽  
P Value ◽  
Medical College ◽  
Adverse Neonatal Outcome ◽  
Adverse Neonatal Outcomes ◽  
Nicu Admission

Background: The study was done to identify the maternal and fetal factors contributing to neonatal outcome and to evaluate the correlation between risk factors and adverse neonatal outcome. Subjects and methods: This prospective observational study was conducted on 126 mothers and their neonates fulfilling the selection criteria at Al-Tibri Medical College and Hospital. A self-designed Performa was used to enter data of subjects. Sick neonates were referred to neonatal intensive care unit for admission and management. The results were analyzed by using SPSS version 22. A p-values <0.05 was considered as significant. Results: Out of 126 enrolled subjects, 81% mothers were multigravidas, 31% were unbooked, 13.5% had gestational comorbidities, 15% were drug addict, 2% were Hepatitis B positive. 22.2% underwent emergency LSCS while 31.7% delivered babies by elective LSCS. Regarding fetal factors contributing to sick babies, IUGR (20%), twin fetuses (15.4%), prematurity (47.7%) were significant. 65 were sick babies. Adverse neonatal outcomes observed were prematurity in 25.4%, IUGR in 11.1%, NICU admission in 33.3%, and neonatal death in 2%. Risk factors associated with adverse neonatal outcomes were positive maternal drug addiction (p-value = 0.028), preterm delivery (p-value<0.001), NICU admission (p-value<0.001) and low birth weight (p-value <0.001). Conclusion: Compromised maternal antenatal care has profound deleterious effect on fetus and neonate. Obstetricians, perinatologists and neonatologists need to work in concord to improve maternal antenatal care hence improving neonatal outcome. In our study adverse neonatal outcome was associated with unbooked cases, delivery by EmLSCS, addicted mother, preterm delivery, LBW and neonates requiring NICU admission.

scholarly journals Gastroschisis: Antenatal Sonographic Predictors of Adverse Neonatal Outcome

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Rachael Page ◽  
Zachary Michael Ferraro ◽  
Felipe Moretti ◽  
Karen Fung Kee Fung
Keyword(s):  
Neonatal Outcome ◽  
Adverse Outcomes ◽  
Abdominal Circumference ◽  
Future Research ◽  
Adverse Neonatal Outcome ◽  
Not Otherwise Specified ◽  
Adverse Neonatal Outcomes ◽  
Clinically Significant ◽  
Key Terms ◽  
Bowel Dilatation

Objectives. The aim of this review was to identify clinically significant ultrasound predictors of adverse neonatal outcome in fetal gastroschisis.Methods. A quasi-systematic review was conducted in PubMed and Ovid using the key terms “gastroschisis,” “predictors,” “outcome,” and “ultrasound.”Results. A total of 18 papers were included. The most common sonographic predictors were intra-abdominal bowel dilatation (IABD), intrauterine growth restriction (IUGR), and bowel dilatation not otherwise specified (NOS). Three ultrasound markers were consistently found to be statistically insignificant with respect to predicting adverse outcome including abdominal circumference, stomach herniation and dilatation, and extra-abdominal bowel dilatation (EABD).Conclusions. Gastroschisis is associated with several comorbidities, yet there is much discrepancy in the literature regarding which specific ultrasound markers best predict adverse neonatal outcomes. Future research should include prospective trials with larger sample sizes and use well-defined and consistent definitions of the adverse outcomes investigated with consideration given to IABD.

scholarly journals The Burden of Adverse Neonatal Outcome among Antenatal Substance Users in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110196
Author(s):  
Wubet Alebachew Bayih ◽  
Metadel Yibeltal Ayalew ◽  
Melaku Tadege ◽  
Maru Mekie ◽  
Teklehaimanot Kiros ◽  
...  
Keyword(s):  
Neonatal Outcome ◽  
Birth Outcome ◽  
Meta Analysis ◽  
Neonatal Outcomes ◽  
Data Bases ◽  
Substance Users ◽  
Adverse Neonatal Outcome ◽  
Pooled Prevalence ◽  
Adverse Neonatal Outcomes ◽  
International Data

Background. Substances mainly khat, alcohol and cigarette are used during pregnancy in Ethiopia. However, to this date, there is no pooled evidence about the burden of adverse neonatal outcomes among the substance users during pregnancy in the country. Methods. Eligible primary studies were accessed from 4 international data bases (Google Scholar, Science Direct, Scopus, and PubMed). The required data were extracted from these studies and then exported to stata version 14 for analysis. Subgroup analyses were conducted for evidence of heterogeneity. Results. A total of 2298 neonates were included from 7 studies. Among these neonates, 530(23.06%) were those whose mothers used substance during pregnancy (exposed group) whereas 1768 neonates were those whose mothers didn’t use substance during pregnancy (controls group). The pooled prevalence of adverse neonatal outcome among the exposed mothers was 38.32% (95% CI: 29.48%, 47.16%; I2 = 76.3%) whereas it was 16.29% (95% CI: 9.45%, 23.13%) among the controls. Adverse neonatal outcome was most burdensome among cigarette smokers 45.20% (95% CI: 37.68%, 52.73%; I2 = .00%) when compared with khat chewers 34.00% (95% CI: 20.87%, 47.13%) and alcohol drinkers 38.47% (95% CI: 17.96%, 58.98%). Low birth weight 42.00% (95% CI: 18.01%, 65.99%; I2 = 91.8%) was the most common adverse birth outcome. Conclusion. It was found that adverse neonatal outcomes were much more burdensome among antenatal substance users than the controls. Therefore, mothers should be enabled to quit using substance before pregnancy. Besides, strict comprehensive screening of every pregnant mother should be made at antenatal care clinics for early identification and management of antenatal substance use.

The effect of a prolonged time interval between antenatal corticosteroid administration and delivery on outcomes in preterm neonates: a cohort study

2007 ◽  
Vol 196 (5) ◽  
pp. 457.e1-457.e6 ◽  
Author(s):  
Allison M. Ring ◽  
Jeffery S. Garland ◽  
Brian R. Stafeil ◽  
Margaret H. Carr ◽  
Gail S. Peckman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Neonates ◽  
Time Interval ◽  
Antenatal Corticosteroid ◽  
Corticosteroid Administration ◽  
Prolonged Time

scholarly journals Study of changes in non-stress test following antenatal corticosteroid therapy in preterm pregnancy

2019 ◽  
Vol 8 (11) ◽  
pp. 4435
Author(s):  
Renuka S. ◽  
Sathiya S. ◽  
Famida A. M. ◽  
Vijayalakshmi K. ◽  
Sailatha R.
Keyword(s):  
Tamil Nadu ◽  
Stress Test ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Antenatal Corticosteroid ◽  
Corticosteroid Administration

Background: Preterm birth is the largest unsolved problem in obstetrics and the single most significant cause of neonatal morbidity and mortality. Preterm labour constitutes 5-10% of pregnancies and is the leading cause of neonatal morbidity and mortality worldwide. It is a major public health problem in terms of loss of life, long term disability (cerebral palsy, blindness, deafness, chronic lung disease). The objectives of this study were to determine whether antenatal corticosteroid administration affects the non-stress test. To evaluate the effect of antenatal steroid on foetal movements. To assess the incidence of respiratory distress syndrome and neonatal mortality after antenatal corticosteroid administration.Methods: All antenatal cases between 28-32 weeks of gestation judged to be at risk for preterm delivery attending the outpatient department or admitted in a tertiary care hospital, Tamil Nadu during the study period of 3 years.Results: The present study was undertaken to evaluate the NST for a period of 3 days following antenatal corticosteroid administration and to study the immediate changes in the mother and the foetus. We found out that there was a statistically significant change (p <0.01) in non-stress test when compared with the pre-betamethasone assay.Conclusions: Corticosteroids can cause metabolic alterations in mother, short- and long-term effect in the foetus.

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