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Efficacy of antenatal corticosteroids according to maternal and perinatal factors. Short Title: Antenatal corticosteroids and pulmonary surfactant

  • Lefèvre, Claire
Publication Date
Apr 23, 2014
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Background : Pregnant women at risk of preterm delivery receive the same dose of antenatal corticosteroids (ACS) to decrease incidence and severity of respiratory distress syndrome (RDS) in preterm infants.Aim : To evaluate whether the effect of ACS on RDS incidence was different in singleton or multiple pregnancies, according to maternal obesity, and in pregnancies with hypertension or preeclampsia.Study design : Retrospective cohort study performed in a level III Regional Maternity Ward. The population was composed of mother-infant couples: all inborn infants < 34 weeks gestation and hospitalised in our Neonatal Intensive Care Unit in Nancy, and mothers delivering before 34 weeks gestation and hospitalised before delivery.Results : 1173 subjects were included in this study: 638 preterm infants and 535 mothers. The number of ACS doses and of pulmonary surfactant (PS) were negatively correlated (r=-0.15, P=0.0002). In multiple logistic regression analysis, lower gestational age (GA) and caesarean section were significantly associated with PS in single pregnancies, respectively (OR, 95%Cl): 2.0 [1.7 - 2.4], and 3.6 [1.8 - 7.1]; whereas only GA was associated with PS in twin or higher order pregnancies, respectively 2.7 [1.9 - 4.1], and 1.8 [0.6 - 5.4]. Preterm infants of obese women didn't receive more PS than other preterm infants: OR=0.67 [0.13-1.40].Conclusion : This study showed that a higher number of ACS doses was associated with less PS doses. Caesarean section and low GA increased risk of RDS, independently from ACS administration, but maternal obesity and multiple pregnancies didn't

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