Antenatal corticosteroid therapy is associated with a lower risk of cystic periventricular leukomalacia.
antenatal corticosteroids
bronchopulmonary dysplasia
cystic periventricular leukomalacia
intraventricular haemorrhage
necrotising enterocolitis
neonatal morbidities
sepsis
Journal
Acta paediatrica (Oslo, Norway : 1992)
ISSN: 1651-2227
Titre abrégé: Acta Paediatr
Pays: Norway
ID NLM: 9205968
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
23
12
2020
received:
22
10
2020
accepted:
20
01
2021
pubmed:
24
1
2021
medline:
9
6
2021
entrez:
23
1
2021
Statut:
ppublish
Résumé
To evaluate the association of antenatal corticosteroids (ACS) therapy on the risk for cystic periventricular leukomalacia (c-PVL) in very low birth weight (VLBW), very preterm infants, whilst accounting for the occurrence of major neonatal morbidities; sepsis, necrotising enterocolitis, intraventricular haemorrhage and bronchopulmonary dysplasia. Population-based observational cohort study applying data collected by the Israel national VLBW infant database from 1995-2016. Cystic PVL was diagnosed in 692 (6.8%) of the 10,170 study infants. Among 7522 infants exposed to ACS, the rate of c-PVL was 5.4%, compared to 10.7% among those not exposed (p < 0.0001). ACS was associated with significantly lower odds for c-PVL (Odds Ratio [OR] 0.69, 95% confidence interval [CI] 0.57-0.84). In subgroup analyses, excluding infants with one or more morbidities the rates of c-PVL ranged from 2.7% to 5.4% among infants exposed to ACS compared to 5.6% to 10.7% in those not exposed (all p < 0.0001). ACS was associated with significantly lower OR's for c-PVL in all subgroups, ranging from 0.52 (95% CI 0.40-0.66) to 0.62 (95% CI 0.50-0.77). Infants exposed to ACS had a significantly lower risk of c-PVL. Subgroup analyses excluding infants with major neonatal comorbidities showed a consistent reduction of 40%-50% in the risk for c-PVL following ACS therapy.
Substances chimiques
Adrenal Cortex Hormones
0
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1795-1802Informations de copyright
©2021 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Références
Antenatal corticosteroids revisited: repeat courses - National Institutes of Health Consensus Development Conference Statement, August 17-18, 2000. National Institutes of Health Consensus Development Panel Obstet Gynecol. 2001;98:144-150.
Roberts D, Brown J, Medly N, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2017;3(3):CD004454.
Canterino JC, Verma U, Visintainer PF, Elimian A, Klein SA, Tejani N. Antenatal steroids and neonatal periventricular leukomalacia. Obstet Gynecol. 2001;97:135-139.
Agarwal R, Chiswick ML, Rimmer S, et al. Antenatal steroids are associated with a reduction in the incidence of cerebral white matter lesions in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed. 2002;86:96-101.
Chawla S, Natarajan G, Shankaran S, et al. National Institute of Child Health and Human Development Neonatal Research Network. Association of neurodevelopmental outcomes and neonatal morbidities of extremely premature infants with differential exposure to antenatal steroids. JAMA Pediatr. 2016;170:1164-1172.
Lee BH, Stoll BJ, McDonald SA, Higgins RD. National Institute of Child Health and Human Development Neonatal Research Network. Adverse neonatal outcomes associated with antenatal dexamethasone versus antenatal betamethasone. Pediatrics. 2006;117:1503-1510.
Sasaki Y, Ikeda T, Nishimura K, et al. Association of antenatal corticosteroids and the mode of delivery with the mortality and morbidity of infants weighing less than 1500 g at birth in Japan. Neonatology. 2014;106:81-86.
Gagliardi L, Lucchini R, Bellu R, Zanini R. Antenatal corticosteroid prophylaxis in singleton and multiple pregnancies. Paediatr Perinatal Epidemiol. 2017;31:394-401.
Baud O, Foix-L'Helias L, Kaminski M, et al. Antenatal glucocorticoid treatment and cystic periventricular leukomalacia in very premature infants. N Engl J Med. 1999;341:1190-1196.
Kusters CDJ, Chen ML, Follett PL, Dammann O. "Intraventricular" hemorrhage and cystic periventricular leukomalacia in preterm infants: How are they related? J Child Neurol. 2009;24:1158-1170.
Kuban K, Sanocka U, Leviton A, et al. White matter disorders of prematurity: association with intraventricular hemorrhage and ventriculomegaly. J Pediatr. 1999;134:539-546.
Shah DK, Doyle LW, Anderson PJ, et al. Adverse neurodevelopment in preterm infants with postnatal sepsis or necrotizing enterocolitis is mediated by white matter abnormalities on magnetic resonance imaging at term. J Pediatr. 2008;153:170-175.
Volpe JJ. Postnatal sepsis, necrotizing entercolitis, and the critical role of systemic inflammation in white matter injury in premature infants. J Pediatr. 2008;153:160-163.
Gagliardi L, Bellù R, Zanini R, Dammann O, Network Neonatal Lombardo Study Group. Bronchopulmonary dysplasia and brain white matter damage in the preterm infant: a complex relationship. Paediatr Perinat Epidemiol. 2009;23:582-590.
Riskin-Mashiah S, Riskin A, Bader D, et al. Israel Neonatal Network. Antenatal corticosteroid treatment in singleton, small-for-gestational-age infants born at 24-31 weeks’ gestation: a population-based study. BJOG. 2016;123:1779-1786.
Kramer MS, Platt RW, Wen SW, et al. A new and improved population-based Canadian reference for birth weight for gestational age. Pediatr. 2001;108:e35.
Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J. Pediatr. 1978;92:529-534.
Bancalari E, Abdenour GE, Feller R, Gannon J. Bronchopulmonary dysplasia: clinical presentation. J. Pediatr. 1979;95:819-823.
Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Annals Surg. 1978;187:1-7.
Blickstein I, Reichman B, Lusky A, Shinwell ES. Israel Neonatal Network. Plurality-dependent risk of severe intraventricular hemorrhage among very low birth weight infants and antepartum corticosteroid treatment. Am J Obstet Gynecol. 2006;194:1329-1333.
Baud O, Zupan V, Lacaze-Masmonteil T, et al. The relationships between antenatal management, the cause of delivery and neonatal outcome in a large cohort of very preterm singleton infants. BJOG. 2000;107:877-884.
Carlo WA, Fanaroff AA, Vohr BR, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Association of antenatal corticosteroids with mortality and neurodevelopmental outcomes among infants born at 22 to 25 weeks’ gestation. JAMA. 2011;306:2348-2358.
Norman M, Piedvache A, Børch K, et al. Effective Perinatal Intensive Care in Europe (EPICE) Research Group. Association of short antenatal corticosteroid administration-to-birth intervals with survival and morbidity among very preterm infants. Results from the EPICE cohort. JAMA Pediatr. 2017;171:678-686.
Wagenaar N, Chau V, Groenendaal F, et al. Clinical risk factors for punctate white matter lesions on early magnetic resonance imaging in preterm newborns. J Pediatr. 2017;182:34-40.
Khwaja O, Volpe JJ. Pathogenesis of cerebral white matter injury of prematurity. Arch Dis Child Fetal Neonatal Ed. 2008;93:153-161.
Kadhim H, Tabarki B, Verellen G, De Prez C, Rona AM, Sebire G. Inflammatory cytokines in the pathogenesis of periventricular leukomalacia. Neurologica. 2001;56:1278-1284.
Kent A, Lomas F, Hurrion E, Dahlstrom JE. Antenatal steroids may reduce adverse neurological outcome following chorioamnionitis: Neurodevelopmental outcome and chorioamnionitis in premature infants. Paediatr Child Health. 2005;41:186-190.
Riskin-Mashiah S, Reichman B, Bader D, et al. Israel Neonatal Network. Population-based study on antenatal corticosteroid treatment in preterm small for gestational age and non-small for gestational age twin infants. J. Mat Fetal & Neonat Med. 2018;31:553-559.