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01-12-2015 | Maternal-Fetal Medicine

Long-term outcomes of antenatal corticosteroids treatment in very preterm infants after chorioamnionitis

Authors: Ken Miyazaki, Madoka Furuhashi, Kaoru Ishikawa, Koji Tamakoshi, Kazutoshi Hayashi, Akihiro Kai, Hiroshi Ishikawa, Nao Murabayashi, Tomoaki Ikeda, Yumi Kono, Satoshi Kusuda, Masanori Fujimura

Published in: Archives of Gynecology and Obstetrics | Issue 6/2015

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.

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Title: Long-term outcomes of antenatal corticosteroids treatment in very preterm infants after chorioamnionitis
Authors: Ken Miyazaki
Madoka Furuhashi
Kaoru Ishikawa
Koji Tamakoshi
Kazutoshi Hayashi
Akihiro Kai
Hiroshi Ishikawa
Nao Murabayashi
Tomoaki Ikeda
Yumi Kono
Satoshi Kusuda
Masanori Fujimura
Publication date: 01-12-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 6/2015
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-015-3762-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term outcomes of antenatal corticosteroids treatment in very preterm infants after chorioamnionitis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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