Top

Published in:

01-12-2013 | Review

Retrospective analysis on the efficacy of corticosteroid prophylaxis prior to elective caesarean section to reduce neonatal respiratory complications at term of pregnancy: review of literature

Authors: Simone Paganelli, Emanuele Soncini, Giancarlo Gargano, Francesco Capodanno, Cristina Vezzani, Giovanni Battista La Sala

Published in: Archives of Gynecology and Obstetrics | Issue 6/2013

Abstract

Purpose

Our purpose was to conduct a systematic review of the literature to determine whether synthetic pharmaceutical glucocorticoids (betamethasone and dexamethasone) are safe as well as effective in reducing neonatal respiratory morbidity at term of pregnancy prior to elective caesarean section. The overall incidence of respiratory disorders is estimated at 2.8 %, and the main risk factors are gestational age and mode of delivery. Newborns delivered by elective caesarean section (CS after 37 weeks) are more susceptible to serious respiratory complications than babies born by vaginal delivery. Neonatal respiratory morbidity at term of pregnancy is low but not negligible. Further, it is increasing due to a drastic decline in trial of labour in those pregnant women who underwent a caesarean section in the past. Because prophylaxis is inexpensive, easy to administer, and safe, other studies should be conducted to confirm its effectiveness.

Methods

We conducted a systematic review of literature since 1965 on the discovery of action mechanisms, pharmaceutical development, proper dosage, and potential side effects of corticosteroids on the mother and offspring to extrapolate their efficacy as no clinical trial has directly demonstrated it.

Results

We extrapolated no negative effects on mother and foetus behaviour.

Conclusions

Human studies suggest that corticosteroid administration may become a proper clinical indication prior to caesarean section in the reduction of neonatal respiratory problems.

Rubaltelli FF, Bonafe L, Tangucci M, Spagnolo A, Dani C (1998) Epidemiology of neonatal acute respiratory disorders. A multicenter study on incidence and fatality rates of neonatal acute respiratory disorders according to gestational age, maternal age, pregnancy complications and type of delivery. Italian Group of Neonatal Pneumology. Biol Neonate 74:7–15PubMedCrossRef

Zanardo V, Simbi AK, Franzoi M, Solda G, Salvadori A, Trevisanuto D (2004) Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery. Acta Paediatr 93:643–647PubMedCrossRef

Farchi S, Di Lallo D, Franco F, Polo A, Lucchini R, Calzolari F, De Curtis M (2009) Neonatal respiratory morbidity and mode of delivery in a population-based study of low-risk pregnancies. Acta Obstet Gynecol Scand 88:729–732PubMedCrossRef

Gerten KA, Coonrod DV, Bay RC, Chambliss LR (2005) Cesarean delivery and respiratory distress syndrome: does labor make a difference? Am J Obstet Gynecol 193:1061–1064PubMedCrossRef

Hansen AK, Wisborg K, Uldbjerg N, Henriksen TB (2008) Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study. BMJ 336:85–87PubMedCrossRef

Goldberg JD, Cohen WR, Friedman EA (1981) Cesarean section indication and the risk of respiratory distress syndrome. Obstet Gynecol 57:30–32PubMed

American Academy of Pediatrics, American College of Obstetricians and Gynecologists (2002) Guidelines for perinatal care, 5th edn. AAP/ACOG, Elk Grove Village/Washington, p 148

National Collaborating Centre for Women’s and Children’s Health (2004) Caesarean section. National Institute for Clinical Excellence, Clinical Guideline, London

Uddin SF, Simon AE (2012) Rates and success rates of trial of labor after cesarean delivery in the United States, 1990–2009. Matern Child Health J

10.

Mathews TJ, Menacker F, MacDorman MF (2004) Centers for disease control and prevention, National center for health statistics. Infant mortality statistics from the 2002 period: linked birth/infant death data set. Natl Vital Stat Rep 53:1–29PubMed

11.

Smith GC, Pell JP, Cameron AD, Dobbie R (2002) Risk of perinatal death associated with labor after previous cesarean delivery in uncomplicated term pregnancy. J Am Med Assoc 287:2684–2690CrossRef

12.

Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW, Moawad AH, Caritis SN, Harper M, Wapner RJ, Sorokin Y, Miodovnik M, Carpenter M, Peaceman AM, O’Sullivan MJ, Sibai B, Langer O, Thorp JM, Ramin SM, Mercer BM, Gabbe SG (2004) Maternal e perinatal outcomes associated with a trial of labour after prior cesarean section. N Engl J Med 351(25):2581–2589PubMedCrossRef

13.

Peter Stutchfield, Rhiannon Whitaker, Ian Russell (2005) Antenatal betamethasone and incidence of neonatal respiratory distress after elective caesarean section: pragmatic randomised trial. BMJ doi:10.1136/bmj.38547.416493.06

14.

Tanasijevic MJ, Wybenga DR, Richardson D, Greene MF, Lopez R, Winkelman JW (1994) A predictive model for fetal lung maturity employing gestational age and test results. Am J Clin Pathol 102:788–793PubMed

15.

Baines DL, Folkesson HG, Norlin A, Bingle CD, Yuan HT, Olver RE (2000) The influence of mode of delivery, hormonal status and postnatal O₂ environment on epithelial sodium channel (ENaC) expression in perinatal guinea-pig lung. J Physiol 522:147–157PubMedCrossRef

16.

Jain L (1999) Alveolar fluid clearance in developing lungs and its role in neonatal transition. Clin Perinatol 26:585–599PubMed

17.

Gowen CW Jr, Lawson EE, Gingras J, Boucher RC, Gatzy JT, Knowles MR (1988) Electrical potential difference and ion transport across nasal epithelium of term neonates: correlation with mode of delivery, transient tachypnea of the new born and respiratory rate. J Pediatr 113:121–127PubMedCrossRef

18.

Venkatesh VC, Katzberg HD (1997) Glucocorticoid regulation of epithelial sodium channel genes in human fetal lung. Am J Physiol 273:227–233

19.

Jain L, Eaton DC (2006) Physiology of fetal lung fluid clearance and effect of labor. Semin Perinatol 30:34–43PubMedCrossRef

20.

Jobe AH, Ikegami M, Padbury J, Polk DH, Korirnilli A, Gonzales LW, Ballard PL (1997) Combined effects of fetal beta agonist stimulation and glucocorticoids on lung function of preterm lambs. Biol Neonate 72:305–313PubMedCrossRef

21.

Noone PG, Leigh MW, Sannuti A, Noone PG, Leigh MW, Sannuti A, Minnix SL, Carson JL, Hazucha M, Zariwala MA, Knowles MR (2004) Primary ciliary dyskinesia: diagnostic and phenotypic features. Am J Respir Crit Care Med 169:459–467PubMedCrossRef

22.

Ballard PL, Ballard A (1995) Scientific basis and therapeutic regimens for use of antenatal glucocorticoids. Am J Obstet Gynecol 173:254–262PubMedCrossRef

23.

Travis R, Sayers G (1965) In: Goodman LS, Gilman A (eds) The pharmacological basis of therapeutics, 3rd edn. Macmillan, New York, pp 1608–1648

24.

Liggins GC (1969) Premature delivery of foetal lambs infused with glucocorticoids. J Endocrinol 45:515–523PubMedCrossRef

25.

Beitins IZ, Kowarski A, Shermeta DW, De Lemos RA, Migeon CJ (1970) Fetal and maternal secretion rate of cortisol in sheep: diffusion resistance of the placenta. Pediatr Res 4:129–134PubMedCrossRef

26.

Simmer HH, Dignam WJ, Easterling WE Jr, Frankland MV, Naftolin F (1966) Neutral C-19 steroids and steroid sulfates in human pregnancy. Steroids 8:179–193PubMedCrossRef

27.

Friedman SB, Glasgow LA, Crota LJ (1970) Plasma adrenocorticosteroid levels during experimental infections (abst.), 69th edn. The American Pediatric Society, Atlantic City, p 16

28.

Liggins GC, Howie RN (1972) A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics 50:515–525PubMed

29.

Gilstrap LC, Christensen R, Clewell WH MD, D’Alton ME, Davidson EC MD, Escobedo MB, Gjerdingen DK et al (1995) Effect of corticosteroid for fetal maturation on perinatal outcomes. NIH consensus development panel on the effect of corticosteroids for fetal maturation on perinatal outcomes. J Am Med Assoc 273:413–418CrossRef

30.

Feldman DM, Carbone J, Belden L, Borgida AF, Herson V (2007) Betamethasone vs dexamethasone for the prevention of morbidity in very-low-birthweight neonates. Am J Obstet Gynecol 197:284.e1–284.e4CrossRef

31.

Dyer KY, Alvarez JR, Salamon CG, Apuzzio JJ, Alvarez M, Al-Khan A (2010) The influence of race on the incidence of respiratory distress syndrome after antenatal betamethasone or dexamethasone. J Reprod Med 55(3–4):124–128PubMed

32.

Elimian A, Garry D, Figueroa R, Spitzer A, Wiencek V, Quirk JG (2007) Antenatal betamethasone compared with dexametasone (betacode trial). Obstet Gynecol 110:26–30PubMedCrossRef

33.

Brownfoot FC, Crowther CA, Middleton P (2008) Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth (review).Cochrane Libr doi:10.1002/14651858.CD006764.pub2

34.

Ikegami M, Jobe AH, Newnham J, Polk DH, Willet KE, Sly P (1997) Repetitive prenatal glucocorticoids improve lung function and decrease growth in preterm lambs. Am J Respir Crit Care Med 156:178–184PubMedCrossRef

35.

Newnham JP, Evans SF, Godfrey M, Huang W, Ikegami M, Jobe A (1999) Maternal, but not fetal, administration of corticosteroids restricts fetal growth. J Matern Fetal Med 8:81–87PubMedCrossRef

36.

Moss TJ, Doherty DA, Nitsos I, Sloboda DM, Harding R, Newnham JP (2005) Effects into adulthood of single or repeated antenatal corticosteroids in sheep. Am J Obstet Gynecol 192:146–152PubMedCrossRef

37.

Ogueh O, Johnson MR (2000) The metabolic effect of antenatal corticosteroid therapy. Hum Reprod Update 6:169–176PubMedCrossRef

38.

Ballard RA, Ballard PL, Cnaan A, Pinto-Martin J (1995) Thyrotropin-releasing hormone for prevention of neonatal respiratory disease. Lancet 345:877–882CrossRef

39.

Dalziel SR, Walker NK, Parag V, Mantell C, Rea HH, Rodgers A, Harding JE (2005) Cardiovascular risk factors after antenatal exposure to betamethasone: 30-year follow-up of a randomised controlled trial. Lancet 365:1856–1862PubMedCrossRef

40.

Mildenhall LFJ, Battin MR, Morton SMB, Bevan C, Kuschel CA, Harding JE (2006) Exposure to repeat doses of antenatal glucocorticoids is associated with altered cardiovascular status after birth. Arch Dis Child Fetal Neonatal Ed 91:56–60CrossRef

41.

Dalziel SR, Lim VK, Lambert A, McCarthy D, Parag V, Rodgers A, Harding JE (2005) Antenatal exposure to betamethasone: psychological functioning and health related quality of life 31 years after inclusion in randomised controlled trial. BMJ 33:665CrossRef

42.

French NP, Hagan R, Evans SF, Mullan A, Newnham JP (2004) Repeated antenatal corticosteroids: effects on cerebral palsy and childhood behaviour. Am J Obstet Gynecol 190:588–595PubMedCrossRef

43.

Lunshof MS, Boer K, Wolf H, Koppen S, Klijn Velderman J, Mulder EJH (2005) Short term (0–48 h) effects of maternal betamethasone administration on fetal heart rate and its variability. Pediatr Res 57:545–549PubMedCrossRef

44.

Mulder EJH, Koenen SV, Blom I, Visser GHA (2004) The effects of antenatal betamethasone administration on fetal heart rate and behaviour depend on gestational age. Early Hum Dev 76:65–77PubMedCrossRef

45.

Mulder EJ, de Heus R, Visser GH (2009) Antenatal corticosteroid therapy: short-term effects on fetal behaviour and haemodynamics. Semin Fetal Neonatal Med 14:151–156PubMedCrossRef

46.

Knight DB, Liggins GC, Wealthall SR (1994) A randomized controlled trial of antepartum thyrotropin-releasing hormone and betamethasone in the prevention of respiratory disease in preterm infants. Am J Obstet Gynecol 171:11–16PubMedCrossRef

47.

Vidaeff AC, Ramin SM, Gilstrap LC, Alcorn JL (2004) Characterization of corticosteroid redosing in an in vitro cell line model. Am J Obstet Gynecol 191:1403–1408PubMedCrossRef

48.

Howie RN, Liggins CC (1982) The New Zealand study of antepartum glucocorticoid treatment. In: Farrell PM (ed) Lung development: biological and clinical perspectives, vol 2. Academic Press, New York, pp 255–265

49.

Langley-Evans SC (2001) Fetal programming of cardiovascular function through exposure to maternal undernutrition. Proc Nutr Soc 60:505–513PubMedCrossRef

50.

Dodic M, Abouantoun T, O’Conor A, Wintour EM, Moritz KM (2002) Programming effects of short prenatal exposure to dexamethasone in sheep. Hypertension 40:729–734PubMedCrossRef

51.

Drake AJ, Tang JI, Nyirenda MJ (2007) Mechanisms underlying the role of glucocorticoids in the early life programming of adult disease. Clin Sci (London) 113:219–232CrossRef

52.

Nyirenda MJ, Dean S, Lyons V, Chapman KE, Seckl JR (2006) Prenatal programming of hepatocyte nuclear factor 4alpha in the rat: a key mechanism in the foetal origins of hyperglycaemia? Diabetologia 49:1412–1420PubMedCrossRef

53.

Crowther CA, McKinlay CJ, Middleton P, Harding JE (2011) Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes. Cochrane Database Syst Rev doi:10.1002/14651858.CD003935.pub3

Title: Retrospective analysis on the efficacy of corticosteroid prophylaxis prior to elective caesarean section to reduce neonatal respiratory complications at term of pregnancy: review of literature
Authors: Simone Paganelli
Emanuele Soncini
Giancarlo Gargano
Francesco Capodanno
Cristina Vezzani
Giovanni Battista La Sala
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 6/2013
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-013-3035-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Retrospective analysis on the efficacy of corticosteroid prophylaxis prior to elective caesarean section to reduce neonatal respiratory complications at term of pregnancy: review of literature

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2013

Is it time to classify various uterine compression suture techniques?

The influence of early diagnosis of endometrioid endometrial cancer on disease stage and survival

Immunohistochemical alterations of cajal-like type of tubal interstitial cells in women with endometriosis and tubal ectopic pregnancy

ERCP without radiation during pregnancy in the minimal invasive world

An approach to evaluate the efficacy of vaginal misoprostol administered for a rapid management of first trimester spontaneous onset incomplete abortion, in comparison to surgical curettage

New member of editorial board: PD Dr. Petra Stute