Evaluation of prenatal corticosteroid use in spontaneous preterm labor in the Brazilian Multicenter Study on Preterm Birth (EMIP)
Objective To evaluate prenatal corticosteroid use in women experiencing spontaneous preterm labor and preterm delivery. Methods The present cross‐sectional multicenter study analyzed interview data from patients attending 20 hospitals in Brazil owing to preterm delivery between April 1, 2011 and Jul...
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| Veröffentlicht in: | International journal of gynecology and obstetrics 2017-11, Vol.139 (2), p.222-229 |
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| container_title | International journal of gynecology and obstetrics |
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| creator | Dias, Tabata Z. Passini, Renato Tedesco, Ricardo P. Lajos, Giuliane J. Rehder, Patricia M. Nomura, Marcelo L. Costa, Maria L. Oliveira, Paulo F. Sousa, Maria H. Cecatti, Jose G. Marba, Sergio T. Guinsburg, Ruth Martinez, Francisco E. Zotarelli, Vilma Gurgel, Lucio T. Feitosa, Francisco E. Chaves, George N. Porto, Ana M. Coutinho, Isabela C. Barbosa Lima, Antonio C. Melo, Elias F. Leite, Débora F. Amorim, Melania M. Melo, Adriana S.O. Melo, Fabiana O. Martins, Marília G. Nunes, Marynea V. Paiva, Cláudio S. Lima, Moises D. Freire, Djacyr M. Tristão, Edson G. Nascimento, Denis J. Menezes, Carlos A. Aquino, Marcelo Vettorazzi, Janete Senger, Cintia E. Assumpção, Augusta M.B. Guedes, Marcela A.F. Moreira, Maria E.L. Borges, Vera T. Maia Filho, Nelson L. Mathias, Jacinta P. Souza, Eduardo Zamarian, Ana C.P. Quintana, Silvana M. Melli, Patrícia P.S. Lotufo, Fátima A. Uzilin, Kaliane Zanette, Elvira A. Andreucci, Carla B. Oliveira, Tenilson A. Oliveira, Laércio R. Santos, Marcos A.N. Sass, Nelson Silveira, Mirian R.F. Coutinho, Pedro R. Siqueira, Luciana |
| description | Objective
To evaluate prenatal corticosteroid use in women experiencing spontaneous preterm labor and preterm delivery.
Methods
The present cross‐sectional multicenter study analyzed interview data from patients attending 20 hospitals in Brazil owing to preterm delivery between April 1, 2011 and July 30, 2012. Patients were stratified based on preterm delivery occurring before 34 weeks or at 34–36+6 weeks of pregnancy, and the frequency of prenatal corticosteroid use at admission was compared. Prenatal corticosteroid use, sociodemographic data, obstetric characteristics, and neonatal outcomes were examined.
Results
There were 1455 preterm deliveries included in the present study; 527 (36.2%) occurred before 34 weeks of pregnancy and prenatal corticosteroids were used in 285 (54.1%) of these pregnancies. Among neonates delivered at 32–33+6 weeks, prenatal corticosteroid use was associated with lower pneumonia (P=0.026) and mortality (P=0.029) rates. Among neonates delivered at 34–36+6 weeks, prenatal corticosteroid use was associated with longer neonatal hospital admission (P |
| doi_str_mv | 10.1002/ijgo.12297 |
| format | Article |
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To evaluate prenatal corticosteroid use in women experiencing spontaneous preterm labor and preterm delivery.
Methods
The present cross‐sectional multicenter study analyzed interview data from patients attending 20 hospitals in Brazil owing to preterm delivery between April 1, 2011 and July 30, 2012. Patients were stratified based on preterm delivery occurring before 34 weeks or at 34–36+6 weeks of pregnancy, and the frequency of prenatal corticosteroid use at admission was compared. Prenatal corticosteroid use, sociodemographic data, obstetric characteristics, and neonatal outcomes were examined.
Results
There were 1455 preterm deliveries included in the present study; 527 (36.2%) occurred before 34 weeks of pregnancy and prenatal corticosteroids were used in 285 (54.1%) of these pregnancies. Among neonates delivered at 32–33+6 weeks, prenatal corticosteroid use was associated with lower pneumonia (P=0.026) and mortality (P=0.029) rates. Among neonates delivered at 34–36+6 weeks, prenatal corticosteroid use was associated with longer neonatal hospital admission (P<0.001), and an increased incidence of 5‐minute Apgar scores below 7 (P=0.010), endotracheal intubation (P=0.042), surfactant use (P=0.006), neonatal morbidities (P=0.048), respiratory distress (P=0.048), and intraventricular hemorrhage (P=0.023).
Conclusion
Preterm labor and late preterm delivery were associated with worse neonatal outcomes following prenatal corticosteroids. This could reflect a sub‐optimal interval between administration and delivery.
Prenatal corticosteroids were associated with worse neonatal outcomes following late preterm delivery; this could reflect a sub‐optimal interval between final corticosteroid dose and delivery.</description><identifier>ISSN: 0020-7292</identifier><identifier>EISSN: 1879-3479</identifier><identifier>DOI: 10.1002/ijgo.12297</identifier><identifier>PMID: 28803456</identifier><language>eng</language><publisher>United States</publisher><subject>Adolescent ; Adult ; Betamethasone - adverse effects ; Betamethasone - therapeutic use ; Brazil ; Drug Administration Schedule ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Late preterm ; Male ; Neonatal outcomes ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Outcome ; Prenatal corticosteroid ; Preterm delivery ; Preterm labor ; Respiratory Distress Syndrome, Newborn - mortality ; Respiratory Distress Syndrome, Newborn - prevention & control ; Young Adult</subject><ispartof>International journal of gynecology and obstetrics, 2017-11, Vol.139 (2), p.222-229</ispartof><rights>2017 International Federation of Gynecology and Obstetrics</rights><rights>2017 International Federation of Gynecology and Obstetrics.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3297-e3e2b77bef710ccb62411985179a5e417e7bf61f3770e3accbe7f72d65cc287e3</citedby><cites>FETCH-LOGICAL-c3297-e3e2b77bef710ccb62411985179a5e417e7bf61f3770e3accbe7f72d65cc287e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijgo.12297$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijgo.12297$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28803456$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dias, Tabata Z.</creatorcontrib><creatorcontrib>Passini, Renato</creatorcontrib><creatorcontrib>Tedesco, Ricardo P.</creatorcontrib><creatorcontrib>Lajos, Giuliane J.</creatorcontrib><creatorcontrib>Rehder, Patricia M.</creatorcontrib><creatorcontrib>Nomura, Marcelo L.</creatorcontrib><creatorcontrib>Costa, Maria L.</creatorcontrib><creatorcontrib>Oliveira, Paulo F.</creatorcontrib><creatorcontrib>Sousa, Maria H.</creatorcontrib><creatorcontrib>Cecatti, Jose G.</creatorcontrib><creatorcontrib>Marba, Sergio T.</creatorcontrib><creatorcontrib>Guinsburg, Ruth</creatorcontrib><creatorcontrib>Martinez, Francisco E.</creatorcontrib><creatorcontrib>Zotarelli, Vilma</creatorcontrib><creatorcontrib>Gurgel, Lucio T.</creatorcontrib><creatorcontrib>Feitosa, Francisco E.</creatorcontrib><creatorcontrib>Chaves, George N.</creatorcontrib><creatorcontrib>Porto, Ana M.</creatorcontrib><creatorcontrib>Coutinho, Isabela C.</creatorcontrib><creatorcontrib>Barbosa Lima, Antonio C.</creatorcontrib><creatorcontrib>Melo, Elias F.</creatorcontrib><creatorcontrib>Leite, Débora F.</creatorcontrib><creatorcontrib>Amorim, Melania M.</creatorcontrib><creatorcontrib>Melo, Adriana S.O.</creatorcontrib><creatorcontrib>Melo, Fabiana O.</creatorcontrib><creatorcontrib>Martins, Marília G.</creatorcontrib><creatorcontrib>Nunes, Marynea V.</creatorcontrib><creatorcontrib>Paiva, Cláudio S.</creatorcontrib><creatorcontrib>Lima, Moises D.</creatorcontrib><creatorcontrib>Freire, Djacyr M.</creatorcontrib><creatorcontrib>Tristão, Edson G.</creatorcontrib><creatorcontrib>Nascimento, Denis J.</creatorcontrib><creatorcontrib>Menezes, Carlos A.</creatorcontrib><creatorcontrib>Aquino, Marcelo</creatorcontrib><creatorcontrib>Vettorazzi, Janete</creatorcontrib><creatorcontrib>Senger, Cintia E.</creatorcontrib><creatorcontrib>Assumpção, Augusta M.B.</creatorcontrib><creatorcontrib>Guedes, Marcela A.F.</creatorcontrib><creatorcontrib>Moreira, Maria E.L.</creatorcontrib><creatorcontrib>Borges, Vera T.</creatorcontrib><creatorcontrib>Maia Filho, Nelson L.</creatorcontrib><creatorcontrib>Mathias, Jacinta P.</creatorcontrib><creatorcontrib>Souza, Eduardo</creatorcontrib><creatorcontrib>Zamarian, Ana C.P.</creatorcontrib><creatorcontrib>Quintana, Silvana M.</creatorcontrib><creatorcontrib>Melli, Patrícia P.S.</creatorcontrib><creatorcontrib>Lotufo, Fátima A.</creatorcontrib><creatorcontrib>Uzilin, Kaliane</creatorcontrib><creatorcontrib>Zanette, Elvira A.</creatorcontrib><creatorcontrib>Andreucci, Carla B.</creatorcontrib><creatorcontrib>Oliveira, Tenilson A.</creatorcontrib><creatorcontrib>Oliveira, Laércio R.</creatorcontrib><creatorcontrib>Santos, Marcos A.N.</creatorcontrib><creatorcontrib>Sass, Nelson</creatorcontrib><creatorcontrib>Silveira, Mirian R.F.</creatorcontrib><creatorcontrib>Coutinho, Pedro R.</creatorcontrib><creatorcontrib>Siqueira, Luciana</creatorcontrib><creatorcontrib>Brazilian Multicenter Study on Preterm Birth (EMIP) study group</creatorcontrib><creatorcontrib>the Brazilian Multicenter Study on Preterm Birth (EMIP) study group</creatorcontrib><title>Evaluation of prenatal corticosteroid use in spontaneous preterm labor in the Brazilian Multicenter Study on Preterm Birth (EMIP)</title><title>International journal of gynecology and obstetrics</title><addtitle>Int J Gynaecol Obstet</addtitle><description>Objective
To evaluate prenatal corticosteroid use in women experiencing spontaneous preterm labor and preterm delivery.
Methods
The present cross‐sectional multicenter study analyzed interview data from patients attending 20 hospitals in Brazil owing to preterm delivery between April 1, 2011 and July 30, 2012. Patients were stratified based on preterm delivery occurring before 34 weeks or at 34–36+6 weeks of pregnancy, and the frequency of prenatal corticosteroid use at admission was compared. Prenatal corticosteroid use, sociodemographic data, obstetric characteristics, and neonatal outcomes were examined.
Results
There were 1455 preterm deliveries included in the present study; 527 (36.2%) occurred before 34 weeks of pregnancy and prenatal corticosteroids were used in 285 (54.1%) of these pregnancies. Among neonates delivered at 32–33+6 weeks, prenatal corticosteroid use was associated with lower pneumonia (P=0.026) and mortality (P=0.029) rates. Among neonates delivered at 34–36+6 weeks, prenatal corticosteroid use was associated with longer neonatal hospital admission (P<0.001), and an increased incidence of 5‐minute Apgar scores below 7 (P=0.010), endotracheal intubation (P=0.042), surfactant use (P=0.006), neonatal morbidities (P=0.048), respiratory distress (P=0.048), and intraventricular hemorrhage (P=0.023).
Conclusion
Preterm labor and late preterm delivery were associated with worse neonatal outcomes following prenatal corticosteroids. This could reflect a sub‐optimal interval between administration and delivery.
Prenatal corticosteroids were associated with worse neonatal outcomes following late preterm delivery; this could reflect a sub‐optimal interval between final corticosteroid dose and delivery.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Betamethasone - adverse effects</subject><subject>Betamethasone - therapeutic use</subject><subject>Brazil</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Late preterm</subject><subject>Male</subject><subject>Neonatal outcomes</subject><subject>Obstetric Labor, Premature</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Prenatal corticosteroid</subject><subject>Preterm delivery</subject><subject>Preterm labor</subject><subject>Respiratory Distress Syndrome, Newborn - mortality</subject><subject>Respiratory Distress Syndrome, Newborn - prevention & control</subject><subject>Young Adult</subject><issn>0020-7292</issn><issn>1879-3479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EoqWw8AOQR0BKsZ0PJyOtSilq1UrAHDnJhbpK48p2QGXjn-OQwsh0w_vcc7oXoUtKhpQQdic3b2pIGUv4EerTmCeeH_DkGPVdSDzOEtZDZ8ZsCCGUU3qKeiyOiR-EUR99Td5F1QgrVY1ViXcaamFFhXOlrcyVsaCVLHBjAMsam52qrahBNaZFXbjFlciUbkO7BjzS4lNWUtR40VROALVj8LNtij12F1aHnZHUdo2vJ4vZ6uYcnZSiMnBxmAP0-jB5GT968-V0Nr6fe7nvPvPAB5ZxnkHJKcnzLGIBpUkcUp6IEALKgWdlREufcwK-cATwkrMiCvOcxRz8AbrtvLlWxmgo052WW6H3KSVp22Pa9pj-9Ojgqw7eNdkWij_0tzgH0A74kBXs_1Gls6fpspN-A6FtgCo</recordid><startdate>201711</startdate><enddate>201711</enddate><creator>Dias, Tabata Z.</creator><creator>Passini, Renato</creator><creator>Tedesco, Ricardo P.</creator><creator>Lajos, Giuliane J.</creator><creator>Rehder, Patricia M.</creator><creator>Nomura, Marcelo L.</creator><creator>Costa, Maria L.</creator><creator>Oliveira, Paulo F.</creator><creator>Sousa, Maria H.</creator><creator>Cecatti, Jose G.</creator><creator>Marba, Sergio T.</creator><creator>Guinsburg, Ruth</creator><creator>Martinez, Francisco E.</creator><creator>Zotarelli, Vilma</creator><creator>Gurgel, Lucio T.</creator><creator>Feitosa, Francisco E.</creator><creator>Chaves, George N.</creator><creator>Porto, Ana M.</creator><creator>Coutinho, Isabela C.</creator><creator>Barbosa Lima, Antonio C.</creator><creator>Melo, Elias F.</creator><creator>Leite, Débora F.</creator><creator>Amorim, Melania M.</creator><creator>Melo, Adriana S.O.</creator><creator>Melo, Fabiana O.</creator><creator>Martins, Marília G.</creator><creator>Nunes, Marynea V.</creator><creator>Paiva, Cláudio S.</creator><creator>Lima, Moises D.</creator><creator>Freire, Djacyr M.</creator><creator>Tristão, Edson G.</creator><creator>Nascimento, Denis J.</creator><creator>Menezes, Carlos A.</creator><creator>Aquino, 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Luciana</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201711</creationdate><title>Evaluation of prenatal corticosteroid use in spontaneous preterm labor in the Brazilian Multicenter Study on Preterm Birth (EMIP)</title><author>Dias, Tabata Z. ; Passini, Renato ; Tedesco, Ricardo P. ; Lajos, Giuliane J. ; Rehder, Patricia M. ; Nomura, Marcelo L. ; Costa, Maria L. ; Oliveira, Paulo F. ; Sousa, Maria H. ; Cecatti, Jose G. ; Marba, Sergio T. ; Guinsburg, Ruth ; Martinez, Francisco E. ; Zotarelli, Vilma ; Gurgel, Lucio T. ; Feitosa, Francisco E. ; Chaves, George N. ; Porto, Ana M. ; Coutinho, Isabela C. ; Barbosa Lima, Antonio C. ; Melo, Elias F. ; Leite, Débora F. ; Amorim, Melania M. ; Melo, Adriana S.O. ; Melo, Fabiana O. ; Martins, Marília G. ; Nunes, Marynea V. ; Paiva, Cláudio S. ; Lima, Moises D. ; Freire, Djacyr M. ; Tristão, Edson G. ; Nascimento, Denis J. ; Menezes, Carlos A. ; Aquino, Marcelo ; Vettorazzi, Janete ; Senger, Cintia E. ; Assumpção, Augusta M.B. ; Guedes, Marcela A.F. ; Moreira, Maria E.L. ; Borges, Vera T. ; Maia Filho, Nelson L. ; Mathias, Jacinta P. ; Souza, Eduardo ; Zamarian, Ana C.P. ; Quintana, Silvana M. ; Melli, Patrícia P.S. ; Lotufo, Fátima A. ; Uzilin, Kaliane ; Zanette, Elvira A. ; Andreucci, Carla B. ; Oliveira, Tenilson A. ; Oliveira, Laércio R. ; Santos, Marcos A.N. ; Sass, Nelson ; Silveira, Mirian R.F. ; Coutinho, Pedro R. ; Siqueira, Luciana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3297-e3e2b77bef710ccb62411985179a5e417e7bf61f3770e3accbe7f72d65cc287e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Betamethasone - adverse effects</topic><topic>Betamethasone - therapeutic use</topic><topic>Brazil</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Late preterm</topic><topic>Male</topic><topic>Neonatal outcomes</topic><topic>Obstetric Labor, Premature</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Prenatal corticosteroid</topic><topic>Preterm delivery</topic><topic>Preterm labor</topic><topic>Respiratory Distress Syndrome, Newborn - mortality</topic><topic>Respiratory Distress Syndrome, Newborn - prevention & control</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dias, Tabata Z.</creatorcontrib><creatorcontrib>Passini, Renato</creatorcontrib><creatorcontrib>Tedesco, Ricardo P.</creatorcontrib><creatorcontrib>Lajos, Giuliane J.</creatorcontrib><creatorcontrib>Rehder, Patricia M.</creatorcontrib><creatorcontrib>Nomura, Marcelo L.</creatorcontrib><creatorcontrib>Costa, Maria L.</creatorcontrib><creatorcontrib>Oliveira, Paulo F.</creatorcontrib><creatorcontrib>Sousa, Maria H.</creatorcontrib><creatorcontrib>Cecatti, Jose G.</creatorcontrib><creatorcontrib>Marba, Sergio T.</creatorcontrib><creatorcontrib>Guinsburg, Ruth</creatorcontrib><creatorcontrib>Martinez, Francisco E.</creatorcontrib><creatorcontrib>Zotarelli, Vilma</creatorcontrib><creatorcontrib>Gurgel, Lucio T.</creatorcontrib><creatorcontrib>Feitosa, Francisco E.</creatorcontrib><creatorcontrib>Chaves, George N.</creatorcontrib><creatorcontrib>Porto, Ana M.</creatorcontrib><creatorcontrib>Coutinho, Isabela C.</creatorcontrib><creatorcontrib>Barbosa Lima, Antonio C.</creatorcontrib><creatorcontrib>Melo, Elias F.</creatorcontrib><creatorcontrib>Leite, Débora F.</creatorcontrib><creatorcontrib>Amorim, Melania M.</creatorcontrib><creatorcontrib>Melo, Adriana S.O.</creatorcontrib><creatorcontrib>Melo, Fabiana O.</creatorcontrib><creatorcontrib>Martins, Marília G.</creatorcontrib><creatorcontrib>Nunes, Marynea V.</creatorcontrib><creatorcontrib>Paiva, Cláudio S.</creatorcontrib><creatorcontrib>Lima, Moises D.</creatorcontrib><creatorcontrib>Freire, Djacyr M.</creatorcontrib><creatorcontrib>Tristão, Edson G.</creatorcontrib><creatorcontrib>Nascimento, Denis J.</creatorcontrib><creatorcontrib>Menezes, Carlos A.</creatorcontrib><creatorcontrib>Aquino, Marcelo</creatorcontrib><creatorcontrib>Vettorazzi, Janete</creatorcontrib><creatorcontrib>Senger, Cintia E.</creatorcontrib><creatorcontrib>Assumpção, Augusta M.B.</creatorcontrib><creatorcontrib>Guedes, Marcela A.F.</creatorcontrib><creatorcontrib>Moreira, Maria E.L.</creatorcontrib><creatorcontrib>Borges, Vera T.</creatorcontrib><creatorcontrib>Maia Filho, Nelson L.</creatorcontrib><creatorcontrib>Mathias, Jacinta P.</creatorcontrib><creatorcontrib>Souza, Eduardo</creatorcontrib><creatorcontrib>Zamarian, Ana C.P.</creatorcontrib><creatorcontrib>Quintana, Silvana M.</creatorcontrib><creatorcontrib>Melli, Patrícia P.S.</creatorcontrib><creatorcontrib>Lotufo, Fátima A.</creatorcontrib><creatorcontrib>Uzilin, Kaliane</creatorcontrib><creatorcontrib>Zanette, Elvira A.</creatorcontrib><creatorcontrib>Andreucci, Carla B.</creatorcontrib><creatorcontrib>Oliveira, Tenilson A.</creatorcontrib><creatorcontrib>Oliveira, Laércio R.</creatorcontrib><creatorcontrib>Santos, Marcos A.N.</creatorcontrib><creatorcontrib>Sass, Nelson</creatorcontrib><creatorcontrib>Silveira, Mirian R.F.</creatorcontrib><creatorcontrib>Coutinho, Pedro R.</creatorcontrib><creatorcontrib>Siqueira, Luciana</creatorcontrib><creatorcontrib>Brazilian Multicenter Study on Preterm Birth (EMIP) study group</creatorcontrib><creatorcontrib>the Brazilian Multicenter Study on Preterm Birth (EMIP) study group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>International journal of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dias, Tabata Z.</au><au>Passini, Renato</au><au>Tedesco, Ricardo P.</au><au>Lajos, Giuliane J.</au><au>Rehder, Patricia M.</au><au>Nomura, Marcelo L.</au><au>Costa, Maria L.</au><au>Oliveira, Paulo F.</au><au>Sousa, Maria H.</au><au>Cecatti, Jose G.</au><au>Marba, Sergio T.</au><au>Guinsburg, Ruth</au><au>Martinez, Francisco E.</au><au>Zotarelli, Vilma</au><au>Gurgel, Lucio T.</au><au>Feitosa, Francisco E.</au><au>Chaves, George N.</au><au>Porto, Ana M.</au><au>Coutinho, Isabela C.</au><au>Barbosa Lima, Antonio C.</au><au>Melo, Elias F.</au><au>Leite, Débora F.</au><au>Amorim, Melania M.</au><au>Melo, Adriana S.O.</au><au>Melo, Fabiana O.</au><au>Martins, Marília G.</au><au>Nunes, Marynea V.</au><au>Paiva, Cláudio S.</au><au>Lima, Moises D.</au><au>Freire, Djacyr M.</au><au>Tristão, Edson G.</au><au>Nascimento, Denis J.</au><au>Menezes, Carlos A.</au><au>Aquino, Marcelo</au><au>Vettorazzi, Janete</au><au>Senger, Cintia E.</au><au>Assumpção, Augusta M.B.</au><au>Guedes, Marcela A.F.</au><au>Moreira, Maria E.L.</au><au>Borges, Vera T.</au><au>Maia Filho, Nelson L.</au><au>Mathias, Jacinta P.</au><au>Souza, Eduardo</au><au>Zamarian, Ana C.P.</au><au>Quintana, Silvana M.</au><au>Melli, Patrícia P.S.</au><au>Lotufo, Fátima A.</au><au>Uzilin, Kaliane</au><au>Zanette, Elvira A.</au><au>Andreucci, Carla B.</au><au>Oliveira, Tenilson A.</au><au>Oliveira, Laércio R.</au><au>Santos, Marcos A.N.</au><au>Sass, Nelson</au><au>Silveira, Mirian R.F.</au><au>Coutinho, Pedro R.</au><au>Siqueira, Luciana</au><aucorp>Brazilian Multicenter Study on Preterm Birth (EMIP) study group</aucorp><aucorp>the Brazilian Multicenter Study on Preterm Birth (EMIP) study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of prenatal corticosteroid use in spontaneous preterm labor in the Brazilian Multicenter Study on Preterm Birth (EMIP)</atitle><jtitle>International journal of gynecology and obstetrics</jtitle><addtitle>Int J Gynaecol Obstet</addtitle><date>2017-11</date><risdate>2017</risdate><volume>139</volume><issue>2</issue><spage>222</spage><epage>229</epage><pages>222-229</pages><issn>0020-7292</issn><eissn>1879-3479</eissn><abstract>Objective
To evaluate prenatal corticosteroid use in women experiencing spontaneous preterm labor and preterm delivery.
Methods
The present cross‐sectional multicenter study analyzed interview data from patients attending 20 hospitals in Brazil owing to preterm delivery between April 1, 2011 and July 30, 2012. Patients were stratified based on preterm delivery occurring before 34 weeks or at 34–36+6 weeks of pregnancy, and the frequency of prenatal corticosteroid use at admission was compared. Prenatal corticosteroid use, sociodemographic data, obstetric characteristics, and neonatal outcomes were examined.
Results
There were 1455 preterm deliveries included in the present study; 527 (36.2%) occurred before 34 weeks of pregnancy and prenatal corticosteroids were used in 285 (54.1%) of these pregnancies. Among neonates delivered at 32–33+6 weeks, prenatal corticosteroid use was associated with lower pneumonia (P=0.026) and mortality (P=0.029) rates. Among neonates delivered at 34–36+6 weeks, prenatal corticosteroid use was associated with longer neonatal hospital admission (P<0.001), and an increased incidence of 5‐minute Apgar scores below 7 (P=0.010), endotracheal intubation (P=0.042), surfactant use (P=0.006), neonatal morbidities (P=0.048), respiratory distress (P=0.048), and intraventricular hemorrhage (P=0.023).
Conclusion
Preterm labor and late preterm delivery were associated with worse neonatal outcomes following prenatal corticosteroids. This could reflect a sub‐optimal interval between administration and delivery.
Prenatal corticosteroids were associated with worse neonatal outcomes following late preterm delivery; this could reflect a sub‐optimal interval between final corticosteroid dose and delivery.</abstract><cop>United States</cop><pmid>28803456</pmid><doi>10.1002/ijgo.12297</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0020-7292 |
| ispartof | International journal of gynecology and obstetrics, 2017-11, Vol.139 (2), p.222-229 |
| issn | 0020-7292 1879-3479 |
| language | eng |
| recordid | cdi_crossref_primary_10_1002_ijgo_12297 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Adult Betamethasone - adverse effects Betamethasone - therapeutic use Brazil Drug Administration Schedule Female Gestational Age Humans Infant, Newborn Late preterm Male Neonatal outcomes Obstetric Labor, Premature Pregnancy Pregnancy Outcome Prenatal corticosteroid Preterm delivery Preterm labor Respiratory Distress Syndrome, Newborn - mortality Respiratory Distress Syndrome, Newborn - prevention & control Young Adult |
| title | Evaluation of prenatal corticosteroid use in spontaneous preterm labor in the Brazilian Multicenter Study on Preterm Birth (EMIP) |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-30T10%3A04%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-wiley_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evaluation%20of%20prenatal%20corticosteroid%20use%20in%20spontaneous%20preterm%20labor%20in%20the%20Brazilian%20Multicenter%20Study%20on%20Preterm%20Birth%20(EMIP)&rft.jtitle=International%20journal%20of%20gynecology%20and%20obstetrics&rft.au=Dias,%20Tabata%20Z.&rft.aucorp=Brazilian%20Multicenter%20Study%20on%20Preterm%20Birth%20(EMIP)%20study%20group&rft.date=2017-11&rft.volume=139&rft.issue=2&rft.spage=222&rft.epage=229&rft.pages=222-229&rft.issn=0020-7292&rft.eissn=1879-3479&rft_id=info:doi/10.1002/ijgo.12297&rft_dat=%3Cwiley_cross%3EIJGO12297%3C/wiley_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/28803456&rfr_iscdi=true |