The influence of antenatal betamethasone timing on neonatal outcome in late preterm infants: a single-center cohort study.

Betamethasone Corticosteroids Newborn Preterm birth Respiratory distress syndrome

Journal

Archives of gynecology and obstetrics

ISSN: 1432-0711

Titre abrégé: Arch Gynecol Obstet

Pays: Germany

ID NLM: 8710213

Informations de publication

Date de publication:
09 Sep 2024

Historique:

received: 05 05 2024

accepted: 19 08 2024

medline: 9 9 2024

pubmed: 9 9 2024

entrez: 9 9 2024

Statut: aheadofprint

Résumé

Many pregnancies continue after antenatal corticosteroid exposure. Since long-term effects on late preterm neonatal outcome remain controversial, it remains unknown whether pregnant women who are at risk for preterm birth during the late preterm period and had prior antenatal corticosteroid exposure would benefit from an additional course of antenatal corticosteroids. We evaluated the need for future trials on this topic by comparing short term effects from antenatal betamethasone to long-term effects. We also examined the value of a risk-adapted approach. We observed neonatal outcomes in late preterm infants (34/0-36/0 weeks of gestation) who were exposed to antenatal betamethasone either up to 10 days prior birth (n = 8) or earlier in pregnancy (n = 89). We examined a real world population from the University Hospital Magdeburg (Germany) between 01 January 2012 and 31 December 2018, and a simulated high-risk population that was derived from the original data. The indicators for relevant adverse outcomes did not differ in the unselected population. In the simulated high-risk population, recent antenatal corticosteroid administration significantly reduced the incidence of relevant cardiorespiratory morbidities (OR = 0.00, p = 0.008), and reduced the number needed to treat from 3.7 to 1.5. The superiority of recent antenatal corticosteroid administration in the late preterm period over earlier exposure strongly depended on the prevalence of respiratory disease. Before considering clinical trials on additional antenatal corticosteroid courses in the late preterm period, antenatal assessment tools to predict respiratory morbidity need to be developed.

Identifiants

DOI: 10.1007/s00404-024-07714-9 PMID: 39249517

pubmed: 39249517

doi: 10.1007/s00404-024-07714-9

pii: 10.1007/s00404-024-07714-9

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Références

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