Purpose: To evaluate the timing of antenatal steroid administration and associated medical interventions in women with imminent preterm birth.
Methods: We performed a prospective observational study at a single tertiary center in Germany from September 2018 to August 2019. We included pregnant women who received antenatal steroids for imminent preterm birth and evaluated the interval from administration to birth. 120 women with antenatal steroid application were included into our analysis. Descriptive statistics were performed to analyze factors influencing the timing of antenatal steroids and to evaluate additional medical interventions which women with imminent preterm birth experience.
Results: Of the 120 women included into our study, 35.8% gave birth before 34/0 weeks and 64.2% before 37/0 weeks of gestation. Only 25/120 women (20.8%) delivered within the optimal time window of 1-7 days after antenatal steroid application. 5/120 women (4.2%) only received one dose of antenatal steroids before birth and 3/120 (2.5%) gave birth within 8 to 14 days after antenatal steroids. Most women gave birth more than 14 days after steroid application (72.5%, 87/120). Women with preeclampsia (60%), PPROM (31%), and FGR (30%) had the highest rates of delivery within the optimal time window. Women of all timing groups received additional interventions and medications like antibiotics, tocolytics, or anticoagulation.
Conclusion: Our observational data indicate that most pregnant women do not give birth within 7 days after the administration of antenatal steroids. The timing was best for preterm birth due to preeclampsia, PPROM, and FGR. Especially for women with symptoms of preterm labor and bleeding placenta previa, antenatal steroids should be indicated more restrictively to improve neonatal outcome and reduce untimely and unnecessary interventions.
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http://dx.doi.org/10.1007/s00404-022-06724-9 | DOI Listing |
J Clin Res Pediatr Endocrinol
December 2024
Department of Pediatric Endocrinology, Marmara University, School of Medicine, Istanbul, Turkiye.
Signs of virilization, such as clitoromegaly, labio-scrotal fusion, and urogenital sinus may be observed in females with 21-hydroxylase deficiency (21-OHD) and other rare virilizing forms of congenital adrenal hyperplasia (CAH). This makes sex determination difficult, and multiple reconstructive surgeries in the postnatal period may be required. As 21-OHD is an autosomal recessive disease, the chance of any child being affected is one in four and so only one in eight will be an affected female.
View Article and Find Full Text PDFAm J Physiol Lung Cell Mol Physiol
December 2024
Department of Pediatrics, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
Intrauterine inflammation from chorioamnionitis (CA) is associated with placental dysfunction and increased risk of bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity. Antenatal steroid (ANS) treatment improves early respiratory outcomes for premature infants. However, it remains unclear whether ANS improve long-term respiratory outcomes, and whether these effects are mediated through improvement of placental dysfunction and/or direct impact on the fetal lung.
View Article and Find Full Text PDFZhonghua Er Ke Za Zhi
December 2024
Division of Neonatology and Center for Newborn Care, Guangzhou Women and Children's Medical Center, Guangzhou510623, China.
To analyze the current status of red blood cell transfusion in very preterm infants (VPI) (gestational age at birth <32 weeks) from Chinese Neonatal Network (CHNN) in 2022. This cross-sectional study was based on the CHNN VPI cohort. It included 6 985 VPI admitted to CHNN 89 participating centers within 24 hours after birth in 2022.
View Article and Find Full Text PDFJ Matern Fetal Neonatal Med
December 2025
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Objective: To assess the neonatal survival rates, maternal complications, neonatal complications, and factors associated with survival rates following periviable premature rupture of membranes (PROM) between 15 and 23 weeks of gestation.
Materials And Methods: The retrospective study included patients with periviable PROM between 15 and 23 weeks of gestation from January 1, 2008, to December 31, 2022. Multivariate regression analysis was performed to identify factors influencing neonatal survival.
Arch Dis Child Fetal Neonatal Ed
December 2024
Bradford Neonatology, Bradford Royal Infirmary Neonatal Unit, Bradford, UK
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