Ken Miyazaki1, Madoka Furuhashi2, Kaoru Ishikawa3, Koji Tamakoshi4, Kazutoshi Hayashi5, Akihiro Kai6, Hiroshi Ishikawa7, Nao Murabayashi8, Tomoaki Ikeda8, Yumi Kono9, Satoshi Kusuda10, Masanori Fujimura11. 1. Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, 3-15 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. goldencaesar21@yahoo.co.jp. 2. Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, 3-15 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. 3. Department of Endowed Chair for Regeneration of Medicine in Kuwana District, Suzuka University of Medical Science, Mie, Japan. 4. Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan. 5. Department of Obstetrics and Gynecology, Kochi Health Sciences Center, Kochi, Japan. 6. Department of Neonatology, Aizenbashi Hospital, Osaka, Japan. 7. Department of Obstetrics, Kanagawa Children's Medical Center, Yokohama, Japan. 8. Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan. 9. Department of Pediatrics, Jichi Medical University, Tochigi, Japan. 10. Department of Neonatology, Maternal and perinatal Center, Tokyo Women's Medical University, Tokyo, Japan. 11. Department of Neonatology, Osaka Medical Center and Research Institute for maternal and Child Health, Osaka, Japan.
Abstract
PURPOSE: To evaluate the effect of antenatal corticosteroids (AC) therapy on short- and long-term outcomes among very low birth weight preterm infants after histologic chorioamnionitis (HCA). METHODS: We performed a retrospective analysis of 5240 single very low birth weight (VLBW) infants born at 22 + 0 and 33 + 6 weeks of gestation between 2003 and 2007, who registered to the Neonatal Research Network Japan. The effects of AC therapy on mortality, neurodevelopmental outcomes at 3 years of age and neonatal morbidities were analyzed in the groups with or without HCA using logistic regression analysis. RESULTS: In the study subjects, 840 were with HCA, 2734 were without HCA, and 1666 were excluded without data for HCA. AC therapy was significantly associated with decreasing mortality before 3 years of age; [0.52 (0.32-0.86)], [odds ratio (95 % confidence intervals]. There were no differences between the two groups regarding neurodevelopmental outcomes, including cerebral palsy [0.90 (0.41-1.99)], development quotient <70 [0.93 (0.48-1.81)], visual impairment [0.46 (0.04-5.18)], and severe hearing impairment [4.00 (0.30-53.4)] in the group with HCA as well as without HCA. Regarding neonatal morbidities, AC therapy was associated with a lower incidence of respiratory distress syndrome [0.67 (0.50-0.91)], sepsis [0.62 (0.41-0.94)], late-onset adrenal insufficiency [0.62 (0.39-0.98)] and an increased incidence of chronic lung disease [1.62 (1.18-2.24)] in the group with HCA. In the group without HCA, AC therapy was associated with decreasing respiratory distress syndrome [0.60 (0.43-0.84)] and increasing chronic lung disease [1.34 (1.11-1.62)]. CONCLUSION: AC therapy is significantly associated with reduced mortality before 3 years of age in VLBW infants with HCA, but not with neurodevelopmental outcomes, which was same as the results found in infants without HCA. AC therapy is recommended for women with suspected chorioamnionitis, as well as those without chorioamnionitis.
PURPOSE: To evaluate the effect of antenatal corticosteroids (AC) therapy on short- and long-term outcomes among very low birth weight preterm infants after histologic chorioamnionitis (HCA). METHODS: We performed a retrospective analysis of 5240 single very low birth weight (VLBW) infants born at 22 + 0 and 33 + 6 weeks of gestation between 2003 and 2007, who registered to the Neonatal Research Network Japan. The effects of AC therapy on mortality, neurodevelopmental outcomes at 3 years of age and neonatal morbidities were analyzed in the groups with or without HCA using logistic regression analysis. RESULTS: In the study subjects, 840 were with HCA, 2734 were without HCA, and 1666 were excluded without data for HCA. AC therapy was significantly associated with decreasing mortality before 3 years of age; [0.52 (0.32-0.86)], [odds ratio (95 % confidence intervals]. There were no differences between the two groups regarding neurodevelopmental outcomes, including cerebral palsy [0.90 (0.41-1.99)], development quotient <70 [0.93 (0.48-1.81)], visual impairment [0.46 (0.04-5.18)], and severe hearing impairment [4.00 (0.30-53.4)] in the group with HCA as well as without HCA. Regarding neonatal morbidities, AC therapy was associated with a lower incidence of respiratory distress syndrome [0.67 (0.50-0.91)], sepsis [0.62 (0.41-0.94)], late-onset adrenal insufficiency [0.62 (0.39-0.98)] and an increased incidence of chronic lung disease [1.62 (1.18-2.24)] in the group with HCA. In the group without HCA, AC therapy was associated with decreasing respiratory distress syndrome [0.60 (0.43-0.84)] and increasing chronic lung disease [1.34 (1.11-1.62)]. CONCLUSION:AC therapy is significantly associated with reduced mortality before 3 years of age in VLBW infants with HCA, but not with neurodevelopmental outcomes, which was same as the results found in infants without HCA. AC therapy is recommended for women with suspected chorioamnionitis, as well as those without chorioamnionitis.
Authors: Celeste Beck; Kelly Gallagher; Leigh A Taylor; Jeffery A Goldstein; Leena B Mithal; Alison D Gernand Journal: Obstet Gynecol Date: 2021-06-01 Impact factor: 7.623
Authors: Nir Melamed; Elizabeth Asztalos; Kellie Murphy; Arthur Zaltz; Donald Redelmeier; Baiju R Shah; Jon Barrett Journal: BMJ Open Date: 2019-09-30 Impact factor: 2.692
Authors: Amélie Boutin; Sarka Lisonkova; Giulia M Muraca; Neda Razaz; Shiliang Liu; Michael S Kramer; K S Joseph Journal: PLoS One Date: 2021-06-30 Impact factor: 3.240