Antenatal corticosteroid therapy, delivery intervals and perinatal mortality in low-resource settings.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-10-05 DOI:10.1093/tropej/fmad037

Stanley Mwita, Benjamin Kamala, Eveline Konje, Deogratias Katabalo, Delfina R Msanga, Karol J Marwa, Namanya Basinda, Gilbert Kongola, Mary Jande, Deborah Dewey

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Abstract

Background: Uncertainty exists regarding the ideal interval between the administration of antenatal corticosteroids (ACS) and delivery. The study's objective was to assess the risks of perinatal mortality and respiratory distress syndrome (RDS) among preterm neonates whose mothers gave birth within 48 h of the administration of ACS and those whose mothers gave birth between 48 h and 7 days.

Methods: The study design was a secondary analysis of data from an observational prospective chart review study that was carried out in Tanzania in 2020. Preterm infants born to mothers who got at least one dose of ACS between 28 and 34 weeks of pregnancy were included.

Results: A total of 346 preterm neonates (294 singletons and 52 twins) were exposed to ACS. Compared to infants born 48 h following the first dose of ACS, those exposed to the drug between 48 h and 7 days had significantly decreased rates of perinatal mortality and RDS. Multivariable analysis revealed that infants exposed ACS between 48 h and 7 days prior to delivery had lower risk of perinatal mortality (aRR 0.30, 95% CI 0.14-0.66) and RDS (aRR 0.27, 95% CI 0.14-0.52).

Conclusion: The first dose of ACS given between 48 h and 7 days before delivery was associated with a lower risk of perinatal mortality and RDS than when the first dose was given <48 h before delivery. To improve neonatal outcomes, healthcare providers should consider administering ACS to mothers at the appropriate time.

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低资源环境下的产前皮质类固醇治疗、分娩间隔和围产期死亡率。

背景:关于产前皮质类固醇(ACS)和分娩之间的理想间隔存在不确定性。该研究的目的是评估母亲在使用ACS后48小时内分娩和母亲在48小时至7天内分娩的早产儿围产期死亡率和呼吸窘迫综合征(RDS)的风险。方法:研究设计是对2020年在坦桑尼亚进行的一项观察性前瞻性图表回顾研究的数据进行二次分析。在怀孕28至34周期间至少服用一剂ACS的母亲所生的早产儿也包括在内。结果:346例早产儿(单胎294例，双胞胎52例)暴露于ACS。与第一次给药48小时后出生的婴儿相比，在48小时至7天期间接触该药物的婴儿围产期死亡率和RDS显著降低。多变量分析显示，在分娩前48小时至7天暴露于ACS的婴儿围产期死亡风险(aRR 0.30, 95% CI 0.14-0.66)和RDS (aRR 0.27, 95% CI 0.14-0.52)较低。结论:分娩前48 h ~ 7天给予第一剂ACS与围生儿死亡率和RDS风险较低相关

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.