Ana Vaz1, Maria Filipa Malheiro2, Milton Severo3,4, Teresa Rodrigues1,2,3, Hercília Guimarães1,2, Nuno Montenegro1,2,3. 1. a Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro , Porto , Portugal. 2. b Department of Obstetrics, Gynecology and Pediatrics , São João Hospital Center , Porto , Portugal. 3. c Epidemiology Research Unit , Institute of Public Health University of Porto , Porto , Portugal. 4. d Department of Clinical Epidemiology, Predictive Medicine and Public Health , University of Porto Medical School , Porto , Portugal.
Abstract
PURPOSE: To compare the effect of antenatal corticosteroids (ACS) on neonatal outcomes among singleton and twin pregnancies and the impact of completeness and timing of ministration. MATERIALS AND METHODS: Retrospective cohort study involving 951 preterm deliveries (25+0-34+6 weeks), between 2006 and 2015. Neonatal outcomes were evaluated according to completeness of ACS ("Complete" n = 441; "Rescue" n = 38; "Incomplete" n = 175; "No ACS" n = 98) and timing of therapy related to delivery ("Before 7 days" n = 260; "After 7 days" n = 181). RESULTS: On respiratory distress syndrome (RDS), odds ratio (OR) for twins was 0.172, 95% confidence interval (CI) was 0.047; 0.591 and for singletons 0.390 (95%CI 0.214; 0.703) for complete or rescue courses, and 0.280 (95%CI 0.069; 1.066) for twins and 0.906 (95%CI 0.482; 1.698) for singletons for incomplete courses. About the need for mechanical ventilation (MV), twins had an OR of 0.189 (95%CI 0.052; 0.642) and singletons of 0.404 (95%CI 0.222; 0.727) for complete or rescue courses and twins had OR = 0.225 (95%CI 0.053; 0.874) and singletons of 0.404 (95%CI 0.222; 0.727) for incomplete courses. About timing, group "After 7 days" had OR = 2.00 for RDS (95%CI 1.21; 3.30) and 2.32 (95%CI 1.42; 3.78) for MV. CONCLUSIONS: ACS improves neonatal outcomes both in singleton and twins. Delivering 7 days after a complete course decreased neonatal morbidity.
PURPOSE: To compare the effect of antenatal corticosteroids (ACS) on neonatal outcomes among singleton and twin pregnancies and the impact of completeness and timing of ministration. MATERIALS AND METHODS: Retrospective cohort study involving 951 preterm deliveries (25+0-34+6 weeks), between 2006 and 2015. Neonatal outcomes were evaluated according to completeness of ACS ("Complete" n = 441; "Rescue" n = 38; "Incomplete" n = 175; "No ACS" n = 98) and timing of therapy related to delivery ("Before 7 days" n = 260; "After 7 days" n = 181). RESULTS: On respiratory distress syndrome (RDS), odds ratio (OR) for twins was 0.172, 95% confidence interval (CI) was 0.047; 0.591 and for singletons 0.390 (95%CI 0.214; 0.703) for complete or rescue courses, and 0.280 (95%CI 0.069; 1.066) for twins and 0.906 (95%CI 0.482; 1.698) for singletons for incomplete courses. About the need for mechanical ventilation (MV), twins had an OR of 0.189 (95%CI 0.052; 0.642) and singletons of 0.404 (95%CI 0.222; 0.727) for complete or rescue courses and twins had OR = 0.225 (95%CI 0.053; 0.874) and singletons of 0.404 (95%CI 0.222; 0.727) for incomplete courses. About timing, group "After 7 days" had OR = 2.00 for RDS (95%CI 1.21; 3.30) and 2.32 (95%CI 1.42; 3.78) for MV. CONCLUSIONS: ACS improves neonatal outcomes both in singleton and twins. Delivering 7 days after a complete course decreased neonatal morbidity.