OBJECTIVES: We sought to examine outcome for premature neonates after multiple courses ofantenatal corticosteroids compared with a single course. STUDY DESIGN: We performed a post hoc nonrandomized analysis on 710 neonates of 25-32 weeks' gestation who were born to mothers enrolled in the North American Thyrotropin-Releasing Hormone Trial and who received 1, 2, or >/=3 courses of antenatal corticosteroids. RESULTS: There was no detectable clinical difference in incidence of respiratory distress syndrome, chronic lung disease, and intraventricular hemorrhage related to courses of antenatal corticosteroids, and outcome was similar for infants delivered at 7-13 days compared with those delivered at 1-6 days after receiving antenatal corticosteroids. Compared with those who received a single course, neonates who received >/=2 courses had lower birth weights (-39 g, P =.02), and those receiving >/=3 courses had increased risk of death (adjusted odds ratio, 2.8; 95% confidence interval, 1.3-5.9; P =.01) and lower levels of plasma cortisol at age 2 hours. CONCLUSION: In this retrospective analysis multiple courses of antenatal corticosteroids did not improve outcome and were associated with increased mortality, decreased fetal growth, and prolonged adrenal suppression.
RCT Entities:
OBJECTIVES: We sought to examine outcome for premature neonates after multiple courses of antenatal corticosteroids compared with a single course. STUDY DESIGN: We performed a post hoc nonrandomized analysis on 710 neonates of 25-32 weeks' gestation who were born to mothers enrolled in the North American Thyrotropin-Releasing Hormone Trial and who received 1, 2, or >/=3 courses of antenatal corticosteroids. RESULTS: There was no detectable clinical difference in incidence of respiratory distress syndrome, chronic lung disease, and intraventricular hemorrhage related to courses of antenatal corticosteroids, and outcome was similar for infants delivered at 7-13 days compared with those delivered at 1-6 days after receiving antenatal corticosteroids. Compared with those who received a single course, neonates who received >/=2 courses had lower birth weights (-39 g, P =.02), and those receiving >/=3 courses had increased risk of death (adjusted odds ratio, 2.8; 95% confidence interval, 1.3-5.9; P =.01) and lower levels of plasma cortisol at age 2 hours. CONCLUSION: In this retrospective analysis multiple courses of antenatal corticosteroids did not improve outcome and were associated with increased mortality, decreased fetal growth, and prolonged adrenal suppression.
Authors: Elke Kuypers; Jennifer J P Collins; Boris W Kramer; Gaston Ofman; Ilias Nitsos; J Jane Pillow; Graeme R Polglase; Matthew W Kemp; John P Newnham; Antonio W D Gavilanes; Relana Nowacki; Machiko Ikegami; Alan H Jobe; Suhas G Kallapur Journal: Am J Physiol Lung Cell Mol Physiol Date: 2011-12-09 Impact factor: 5.464
Authors: Katherine B Wolfe; Candice C Snyder; Tate Gisslen; Matthew W Kemp; John P Newnham; Boris W Kramer; Alan H Jobe; Suhas Kallapur Journal: Reprod Sci Date: 2013-05-07 Impact factor: 3.060
Authors: Chressen Catharina Much; Björn Phillip Schoennagel; Jin Yamamura; Ralph Buchert; Hendrik Kooijman; Anne-Kathrin Schätzle; Gerhard Adam; Ulrike Wedegaertner Journal: Eur Radiol Date: 2013-02-16 Impact factor: 5.315
Authors: Suhas G Kallapur; Pietro Presicce; Cesar M Rueda; Alan H Jobe; Claire A Chougnet Journal: Semin Reprod Med Date: 2014-01-03 Impact factor: 1.303