Background: Before the advent of antenatal steroids, early non-invasive respiratory support (NIV), and intratracheal surfactant, antenatal terbutaline was also used to improve lung compliance and reduce the incidence of respiratory distress syndrome (RDS).
Objectives: The objective of this paper was to study the association between antenatal terbutaline and endotracheal intubation (ET) within the first 24 hours of life, RDS, bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH) in infants with the gestational age (GA) of <32 weeks, and to study the association between antenatal terbutaline, and ET or NIV within the first 24 hours of life, and RDS in infants with the GA of 32 to 36 weeks.
Method: This was a retrospective medical record review of preterm infants delivered at a single tertiary care center from October 2016 to December 2020. Multivariable logistic regression was used to explore the association between antenatal terbutaline and neonatal respiratory support.
Result: 1,794 infants were included, 234 (13.0%) had the GA of <32 weeks and 1,560 (86.9%) had the GA of 32 to 36 weeks. Antenatal terbutaline, corticosteroid, or both agents were administered in 561 (31.3%), 1,461 (81.4%), and 555 (30.9%), respectively. Antenatal terbutaline was significantly associated with a reduction in ET (adjusted odds ratio [aOR] = 0.40, 95% confident interval [CI] 0.19-0.82, = 0.012) in infants with the GA of <32 weeks, but not in infants with the GA of 32-36 weeks. Antenatal terbutaline was not associated with RDS or BPD but was significantly associated with a reduction in grade III-IV IVH (aOR 0.11, CI 0.01-0.98; = 0.048), in infants with the GA of <32 weeks.
Conclusion: In a state-of-the-art neonatal care setting, antenatal terbutaline was associated with a reduction in ET during the first 24 hours in infants with the GA of <32 weeks. The use of antenatal terbutaline to improve acute neonatal respiratory outcomes merits reconsideration.
Key Points: · The neonatal respiratory benefits of antenatal terbutaline in the era of antenatal corticosteroids were uncertain.. · Terbutaline is associated with a reduction in endotracheal intubation in a modern care setting.. · The role of terbutaline, and potentially other betamimetics, to improve neonatal respiratory outcomes merits reconsideration..
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/a-1695-8220 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparison of terbutaline and atosiban as tocolytic agents in intrauterine repair of myelomeningocele: a retrospective cohort study.
Braz J Anesthesiol
May 2024
University of Toronto, Mount Sinai Hospital, Department of Anesthesia and Pain Management, Toronto, Canada; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Departamento de Anestesiologia, São Paulo, SP, Brazil. Electronic address:
Background: Myelomeningocele (MMC) is a neural tube defect disease. Antenatal repair of fetal MMC is an alternative to postnatal repair. Many agents can be used as tocolytics during the in utero fetal repair such as β2-agonists and oxytocin receptor antagonists, with possible maternal and fetal repercussions.
View Article and Find Full Text PDFTerbutaline-triggered fetal arrhythmia prior to neonatal diagnosis of Wolff-Parkinson-White syndrome: A case report.
Case Rep Womens Health
January 2022
University of Wisconsin, Department of Obstetrics and Gynecology, 202 S. Park Street, Madison, WI 53715, United States.
Introduction: Short-term maternal administration of betamimetics is a common obstetric practice with uses including tocolysis during antenatal corticosteroid administration for fetal lung maturity, intrapartum tachysystole, and prior to external cephalic version. While previous research has demonstrated adverse effects of prolonged use of maternal betamimetics, no prior documentation exists of fetal tachyarrhythmias beyond sinus tachycardia after administration of terbutaline.
Case: This case documents a transient fetal tachyarrhythmia consistent with presumed atrial flutter after maternal administration of terbutaline for external cephalic version.
Changing Tocolytic Exposures among Neonatal Intensive Care Unit Admitted Preterm Infants.
Am J Perinatol
December 2022
Department of Pediatrics, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas.
Objective: Since 2010, the American College of Obstetrics and Gynecology have released three committee opinions to recommend and reaffirm the utility of magnesium sulfate for neuroprotection and later for tocolysis to achieve antenatal steroid course completion in preterm labor. We sought to determine changes in antenatal magnesium sulfate exposure and other tocolytic agents for pregnancies resulting in neonatal intensive care unit (NICU)-admitted preterm infants.
Study Design: Using the Pediatrix Clinical Data Warehouse, we evaluated all inborn infants delivered between 22 and 33 weeks' gestation and admitted to the intensive care units from 2009 to 2018.
Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates.
Am J Perinatol
March 2024
Department of Pediatrics, Division of Neonatology and Perinatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background: Before the advent of antenatal steroids, early non-invasive respiratory support (NIV), and intratracheal surfactant, antenatal terbutaline was also used to improve lung compliance and reduce the incidence of respiratory distress syndrome (RDS).
Objectives: The objective of this paper was to study the association between antenatal terbutaline and endotracheal intubation (ET) within the first 24 hours of life, RDS, bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH) in infants with the gestational age (GA) of <32 weeks, and to study the association between antenatal terbutaline, and ET or NIV within the first 24 hours of life, and RDS in infants with the GA of 32 to 36 weeks.
Method: This was a retrospective medical record review of preterm infants delivered at a single tertiary care center from October 2016 to December 2020.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!