Ravisha Srinivasjois1,2, Desiree Silva1,2. 1. a Department of Paediatrics , Joondalup Health Campus , Joondalup , Perth , Western Australia , and. 2. b School of Paediatrics and Child Health, University of Western Australia , Perth , Western Australia.
Abstract
BACKGROUND: Elective caesarean section is associated with an increased risk of respiratory morbidity and admission to special care nursery even at full-term gestation. AIM: To systematically review the efficacy of antenatal steroid administration to prevent neonatal morbidity at full-term. Only randomised and quasirandomised controlled trials were selected. METHODS: Standardised methodology as described by the Cochrane neonatal review group was used for data collection and analysis. RESULTS: A total of three randomised controlled trials (N = 2740 patients) were included in the review. Meta-analysis of the published data was carried out. A significant decrease in the risk of respiratory distress syndrome (odds ratio (OR) 0.40 (95%CI: 0.23-0.71, p < 0.001), risk of transient tachypnoea of newborn (OR 0.37 (95%CI: 0.25-0.56, p < 0.00001)), risk of admission to special care nursery (OR 0.53 (95%CI: 0.37-0.76, p < 0.0007)) were observed. CONCLUSION: Although antenatal steroid administration prior to elective caesarean section demonstrated significant benefit in the prevention of neonatal morbidities; however, one need to be cautious before it can be routinely administered because of the paucity of long-term safety data.
BACKGROUND: Elective caesarean section is associated with an increased risk of respiratory morbidity and admission to special care nursery even at full-term gestation. AIM: To systematically review the efficacy of antenatal steroid administration to prevent neonatal morbidity at full-term. Only randomised and quasirandomised controlled trials were selected. METHODS: Standardised methodology as described by the Cochrane neonatal review group was used for data collection and analysis. RESULTS: A total of three randomised controlled trials (N = 2740 patients) were included in the review. Meta-analysis of the published data was carried out. A significant decrease in the risk of respiratory distress syndrome (odds ratio (OR) 0.40 (95%CI: 0.23-0.71, p < 0.001), risk of transient tachypnoea of newborn (OR 0.37 (95%CI: 0.25-0.56, p < 0.00001)), risk of admission to special care nursery (OR 0.53 (95%CI: 0.37-0.76, p < 0.0007)) were observed. CONCLUSION: Although antenatal steroid administration prior to elective caesarean section demonstrated significant benefit in the prevention of neonatal morbidities; however, one need to be cautious before it can be routinely administered because of the paucity of long-term safety data.