Rescue Antenatal Corticosteroids in Late Preterm Birth after Completion of the Initial Cycle of Antenatal Corticosteroids during the Early Preterm Period

IF 0.4 4区 医学 Q4 OBSTETRICS & GYNECOLOGY Clinical and experimental obstetrics & gynecology Pub Date : 2023-10-19 DOI:10.31083/j.ceog5010218
Da Eun Jeong, Jung Yun Lee, Eun Ji Oh, Kyong-No Lee, Hyunsu Kim, Hyeon Ji Kim, Jee Yoon Park, Young Hwa Jung, Kyung Joon Oh, Chang Won Choi
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Abstract

Background: Late preterm birth is associated with increased risks of adverse neonatal outcomes, including respiratory distress syndrome (RDS) and hypoglycemia. The use of antenatal corticosteroids (ACS) has been shown to reduce these risks in early preterm infants. However, the efficacy of rescue ACS in late preterm infants remains uncertain. This study aimed to assess the effectiveness of rescue ACS in reducing the incidence of RDS and hypoglycemia in late preterm infants. Methods: A retrospective cohort study was conducted on women who delivered singleton late preterm infants (34 + 0 to 36 + 6 weeks of gestation) at a tertiary hospital. The inclusion criteria were completion of the initial cycle of ACS in the early preterm period (before 34 + 0 weeks of gestation). Data on maternal baseline characteristics, ACS administration, and neonatal outcomes were collected from medical records. Statistical analyses, including logistic regression and multivariate modeling, were performed to assess the association between rescue ACS and neonatal outcomes. Results: A total of 155 singleton late preterm infants were included in the study. Among them, 27.8% (43/155) received rescue ACS after 34 weeks of gestation, while 72.2% (112/155) did not. Neonates who did not receive rescue ACS had a significantly higher incidence of RDS compared to those who did (10.7% vs. 0%, p = 0.038). However, the results were not statistically significant in the multivariate analysis (odds ratio (OR), 0.07; 95% confidence interval (CI), 0.00–1.48; p = 0.087). Additionally, there were no significant differences in the frequencies of hypoglycemia (glucose level ≤40 mg/dL) (8.0% vs. 9.3%, p = 0.755) and hypoglycemia (glucose level ≤60 mg/dL) (52.7% vs. 37.2%, p = 0.106) between the two groups. Conclusions: Rescue ACS administration in late preterm infants was not associated with a reduced risk of RDS. Additionally, there was no significant difference in the incidence of hypoglycemia. Further studies with larger sample sizes are needed to confirm these results and assess potential long-term implications.
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在早期早产期间完成初始周期的产前皮质激素后,晚期早产的产前皮质激素抢救
背景:晚期早产与新生儿不良结局的风险增加相关,包括呼吸窘迫综合征(RDS)和低血糖。使用产前皮质类固醇(ACS)已被证明可以降低早期早产儿的这些风险。然而,抢救ACS对晚期早产儿的疗效仍不确定。本研究旨在评估抢救ACS在降低晚期早产儿RDS和低血糖发生率方面的有效性。方法:对某三级医院分娩单胎晚期早产儿(妊娠34 + 0 ~ 36 + 6周)的产妇进行回顾性队列研究。纳入标准是在早产早期(妊娠34 + 0周前)完成ACS初始周期。从医疗记录中收集产妇基线特征、ACS给药和新生儿结局的数据。统计分析,包括逻辑回归和多变量模型,评估抢救ACS与新生儿结局之间的关系。结果:本研究共纳入155例单胎晚期早产儿。其中27.8%(43/155)在妊娠34周后接受了抢救性ACS, 72.2%(112/155)未接受抢救性ACS。未接受ACS抢救的新生儿RDS发生率明显高于接受ACS抢救的新生儿(10.7% vs. 0%, p = 0.038)。然而,多变量分析结果无统计学意义(优势比(OR), 0.07;95%置信区间(CI), 0.00-1.48;P = 0.087)。低血糖(血糖≤40 mg/dL)发生率(8.0%比9.3%,p = 0.755)和低血糖(血糖≤60 mg/dL)发生率(52.7%比37.2%,p = 0.106)在两组间无显著差异。结论:晚期早产儿给予ACS抢救与RDS风险降低无关。此外,两组在低血糖发生率上无显著差异。需要更大样本量的进一步研究来证实这些结果并评估潜在的长期影响。
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
241
审稿时长
1 months
期刊介绍: CEOG is an international, peer-reviewed, open access journal. CEOG covers all aspects of Obstetrics and Gynecology, including obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine. All submissions of cutting-edge advances of medical research in the area of women''s health worldwide are encouraged.
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