OBJECTIVES: To determine the risk of fetal, neonatal and maternal mortality and morbidity for women and their infants who remained undelivered more than 7 days following a course of prenatal corticosteroids. DESIGN: Systematic review. POPULATION: Women who gave birth more than 7 days after a course of prenatal corticosteroids compared with women not administered corticosteroids. METHODS: Seven randomised controlled trials were identified which reported outcomes for women and their babies who remained undelivered more than 7 days after exposure to a single course of corticosteroids compared with a placebo/no treatment group. MAIN OUTCOME MEASURES: Fetal, neonatal and maternal mortality and morbidity. RESULTS: Seven trials involving 862 infants, 434 born to corticosteroid treated women and 428 to control women were included in this review. For corticosteroid treated infants there was no reduction in the risk of respiratory distress syndrome (relative risk (RR), 0.72; 95% confidence interval (CI), 0.49-1.07), or stillbirth (RR, 1.67; 95% CI, 0.86-3.25). However, there was a tripling in risk of death for liveborn corticosteroid treated infants (RR, 3.24; 95% CI, 1.32-7.96; P = 0.01), and a doubling in risk of perinatal mortality (RR, 2.13; 95% CI, 1.27-3.57; P < 0.01). Corticosteroid treated infants were born on average 5 days earlier than controls (95% CI, -9.15 to -0.85 days, P = 0.02). Their mothers were more likely to have chorioamnionitis (RR, 2.91; 95% CI, 1.25-6.74; P = 0.01). CONCLUSIONS: Infants exposed to corticosteroids more than 7 days before birth had no reduction in risk of respiratory distress syndrome but increased perinatal mortality.
OBJECTIVES: To determine the risk of fetal, neonatal and maternal mortality and morbidity for women and their infants who remained undelivered more than 7 days following a course of prenatal corticosteroids. DESIGN: Systematic review. POPULATION: Women who gave birth more than 7 days after a course of prenatal corticosteroids compared with women not administered corticosteroids. METHODS: Seven randomised controlled trials were identified which reported outcomes for women and their babies who remained undelivered more than 7 days after exposure to a single course of corticosteroids compared with a placebo/no treatment group. MAIN OUTCOME MEASURES: Fetal, neonatal and maternal mortality and morbidity. RESULTS: Seven trials involving 862 infants, 434 born to corticosteroid treated women and 428 to control women were included in this review. For corticosteroid treated infants there was no reduction in the risk of respiratory distress syndrome (relative risk (RR), 0.72; 95% confidence interval (CI), 0.49-1.07), or stillbirth (RR, 1.67; 95% CI, 0.86-3.25). However, there was a tripling in risk of death for liveborn corticosteroid treated infants (RR, 3.24; 95% CI, 1.32-7.96; P = 0.01), and a doubling in risk of perinatal mortality (RR, 2.13; 95% CI, 1.27-3.57; P < 0.01). Corticosteroid treated infants were born on average 5 days earlier than controls (95% CI, -9.15 to -0.85 days, P = 0.02). Their mothers were more likely to have chorioamnionitis (RR, 2.91; 95% CI, 1.25-6.74; P = 0.01). CONCLUSIONS:Infants exposed to corticosteroids more than 7 days before birth had no reduction in risk of respiratory distress syndrome but increased perinatal mortality.
Authors: Kathryn L Gatford; Julie A Owens; Shaofu Li; Timothy J M Moss; John P Newnham; John R G Challis; Deborah M Sloboda Journal: Am J Physiol Endocrinol Metab Date: 2008-05-20 Impact factor: 4.310
Authors: Helen W Huang; David E Payne; Weizhen Bi; Su Pan; Shirley R Bruce; Joseph L Alcorn Journal: Am J Physiol Lung Cell Mol Physiol Date: 2012-02-24 Impact factor: 5.464
Authors: L F J Mildenhall; M R Battin; S M B Morton; C Bevan; C A Kuschel; J E Harding Journal: Arch Dis Child Fetal Neonatal Ed Date: 2005-09-20 Impact factor: 5.747
Authors: Ashley N Battarbee; Stephanie T Ros; M Sean Esplin; Joseph Biggio; Radek Bukowski; Samuel Parry; Heping Zhang; Hao Huang; William Andrews; George Saade; Yoel Sadovsky; Uma M Reddy; Michael W Varner; Tracy A Manuck Journal: Am J Obstet Gynecol MFM Date: 2019-12-17
Authors: Caroline A Crowther; Fariba Aghajafari; Lisa M Askie; Elizabeth V Asztalos; Peter Brocklehurst; Tanya K Bubner; Lex W Doyle; Sourabh Dutta; Thomas J Garite; Debra A Guinn; Mikko Hallman; Mary E Hannah; Pollyanna Hardy; Kimberly Maurel; Premasish Mazumder; Cindy McEvoy; Philippa F Middleton; Kellie E Murphy; Outi M Peltoniemi; Dawn Peters; Lisa Sullivan; Elizabeth A Thom; Merryn Voysey; Ronald J Wapner; Lisa Yelland; Sasha Zhang Journal: Syst Rev Date: 2012-02-12