Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction
Purpose We assessed the influence of antenatal corticosteroid (ACS) on the inhospital outcomes of intrauterine growth restriction (IUGR) infants. Methods A retrospective study was conducted with singletons born at 23+0 to 33+6 weeks of gestation at Seoul National University Hospital from 2007 to 201...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Neonatology
2018-11-01
|
| Series: | Neonatal Medicine |
| Subjects: | |
| Online Access: | http://www.neo-med.org/upload/pdf/nm-2018-25-4-161.pdf |
| _version_ | 1818329533920575488 |
|---|---|
| author | Yoo Jinie Kim Sung Hwan Choi Sohee Oh Jin A Sohn Young Hwa Jung Seung Han Shin Chang Won Choi Ee-Kyung Kim Han-Suk Kim Beyong Il Kim Jin A Lee |
| author_facet | Yoo Jinie Kim Sung Hwan Choi Sohee Oh Jin A Sohn Young Hwa Jung Seung Han Shin Chang Won Choi Ee-Kyung Kim Han-Suk Kim Beyong Il Kim Jin A Lee |
| author_sort | Yoo Jinie Kim |
| collection | DOAJ |
| description | Purpose We assessed the influence of antenatal corticosteroid (ACS) on the inhospital outcomes of intrauterine growth restriction (IUGR) infants. Methods A retrospective study was conducted with singletons born at 23+0 to 33+6 weeks of gestation at Seoul National University Hospital from 2007 to 2014. We compared clinical outcomes between infants who received ACS 2 to 7 days before birth (complete ACS), at <2 or >7 days (incomplete ACS), and those who did not receive ACS in IUGR and AGA infants. Multivariate logistic regression using Firth’s penalized likelihood was performed. Results 304 neonates with 91 IUGR neonates were eligible. Among AGA neonates, mortality (adjusted odds ratio [aOR], 0.13; 95% confidence interval [CI], 0.02 to 0.78), hypotension within 7 postnatal days (aOR, 0.20; 95% CI, 0.06 to 0.64), and severe bronchopulmonary dysplasia (BPD) or death (aOR, 0.24; 95% CI, 0.07 to 0.77) were lower in complete ACS group after adjusting for pregnancy induced hypertension and uncontrolled preterm labor. Mortality (aOR, 0.18; 95% CI, 0.04 to 0.78), hypotension (aOR, 0.26; 95% CI, 0.09 to 0.70), and severe BPD or death (aOR, 0.33; 95% CI, 0.12 to 0.92) were also lower in the incomplete ACS group. Among IUGR infants, after adjusting for birth weight and 5-minute Apgar score, inhaled nitric oxide use within 14 postnatal days was lower in both complete ACS (aOR, 0.07; 95% CI, 0.01 to 0.67) and incomplete ACS (aOR, 0.04; 95% CI, 0.01 to 0.37) groups. Conclusion ACS was not effective in reducing morbidities in IUGR preterm infants. |
| first_indexed | 2024-12-13T12:49:35Z |
| format | Article |
| id | doaj.art-46448e3f9afe4d8d9efc1ed185b9a8ea |
| institution | Directory Open Access Journal |
| issn | 2287-9412 2287-9803 |
| language | English |
| last_indexed | 2024-12-13T12:49:35Z |
| publishDate | 2018-11-01 |
| publisher | Korean Society of Neonatology |
| record_format | Article |
| series | Neonatal Medicine |
| spelling | doaj.art-46448e3f9afe4d8d9efc1ed185b9a8ea2022-12-21T23:45:22ZengKorean Society of NeonatologyNeonatal Medicine2287-94122287-98032018-11-0125416116910.5385/nm.2018.25.4.161945Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth RestrictionYoo Jinie Kim0Sung Hwan Choi1Sohee Oh2Jin A Sohn3Young Hwa Jung4Seung Han Shin5Chang Won Choi6Ee-Kyung Kim7Han-Suk Kim8Beyong Il Kim9Jin A Lee10 Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, KoreaPurpose We assessed the influence of antenatal corticosteroid (ACS) on the inhospital outcomes of intrauterine growth restriction (IUGR) infants. Methods A retrospective study was conducted with singletons born at 23+0 to 33+6 weeks of gestation at Seoul National University Hospital from 2007 to 2014. We compared clinical outcomes between infants who received ACS 2 to 7 days before birth (complete ACS), at <2 or >7 days (incomplete ACS), and those who did not receive ACS in IUGR and AGA infants. Multivariate logistic regression using Firth’s penalized likelihood was performed. Results 304 neonates with 91 IUGR neonates were eligible. Among AGA neonates, mortality (adjusted odds ratio [aOR], 0.13; 95% confidence interval [CI], 0.02 to 0.78), hypotension within 7 postnatal days (aOR, 0.20; 95% CI, 0.06 to 0.64), and severe bronchopulmonary dysplasia (BPD) or death (aOR, 0.24; 95% CI, 0.07 to 0.77) were lower in complete ACS group after adjusting for pregnancy induced hypertension and uncontrolled preterm labor. Mortality (aOR, 0.18; 95% CI, 0.04 to 0.78), hypotension (aOR, 0.26; 95% CI, 0.09 to 0.70), and severe BPD or death (aOR, 0.33; 95% CI, 0.12 to 0.92) were also lower in the incomplete ACS group. Among IUGR infants, after adjusting for birth weight and 5-minute Apgar score, inhaled nitric oxide use within 14 postnatal days was lower in both complete ACS (aOR, 0.07; 95% CI, 0.01 to 0.67) and incomplete ACS (aOR, 0.04; 95% CI, 0.01 to 0.37) groups. Conclusion ACS was not effective in reducing morbidities in IUGR preterm infants.http://www.neo-med.org/upload/pdf/nm-2018-25-4-161.pdfprenatal caresteroidsfetal growth retardationpremature infantoutcome assessment (health care) |
| spellingShingle | Yoo Jinie Kim Sung Hwan Choi Sohee Oh Jin A Sohn Young Hwa Jung Seung Han Shin Chang Won Choi Ee-Kyung Kim Han-Suk Kim Beyong Il Kim Jin A Lee Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction Neonatal Medicine prenatal care steroids fetal growth retardation premature infant outcome assessment (health care) |
| title | Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction |
| title_full | Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction |
| title_fullStr | Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction |
| title_full_unstemmed | Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction |
| title_short | Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction |
| title_sort | antenatal corticosteroids and clinical outcomes of preterm singleton neonates with intrauterine growth restriction |
| topic | prenatal care steroids fetal growth retardation premature infant outcome assessment (health care) |
| url | http://www.neo-med.org/upload/pdf/nm-2018-25-4-161.pdf |
| work_keys_str_mv | AT yoojiniekim antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT sunghwanchoi antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT soheeoh antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT jinasohn antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT younghwajung antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT seunghanshin antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT changwonchoi antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT eekyungkim antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT hansukkim antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT beyongilkim antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction AT jinalee antenatalcorticosteroidsandclinicaloutcomesofpretermsingletonneonateswithintrauterinegrowthrestriction |