SOLNA,
Sweden -- May 15, 2017 -- Antenatal corticosteroids given to pregnant
women only hours before delivery was associated with a survival
advantage for their preterm infants, according to a study published
online by JAMA Pediatrics.
The findings from the Effective Perinatal Intensive Care in Europe (EPICE) research project suggest that survival and health gains for very preterm infants may occur within hours.
Mikael Norman, MD, Karolinska Institutet, Solna, Sweden, and colleagues have studied outcomes in over 4,500 very preterm infants, born at 24 to 31 weeks of gestation (excluding multiple pregnancies and severe congenital malformations) in 11 countries across Europe.
In this cohort, 15% of the pregnant women were not exposed to antenatal corticosteroids and 21% of the unexposed infants died after birth.
Infants born already 3 hours after corticosteroid administration to the mother had significantly lower mortality than those not exposed to the treatment, and corticosteroid administration 6 to 12 hours before birth was associated with halved risks of infant death.
“Given the current concept of a slow effect, pregnant women at immediate risk of preterm delivery may not receive corticosteroid treatment because it is considered futile,” said Dr. Norman. “Also our results can provide reassurance for clinicians or parents in situations where it is not possible to wait a day or two to reach the full effect of corticosteroid treatment because of the need for action to reduce or stop ongoing morbidity in the pregnant woman and her foetus.”
In the study, antenatal corticosteroid treatment was also associated with a lower risk of severe neonatal morbidity such as bleedings in the brain. This reduction in the risk was associated with longer administration-to-birth intervals.
“Our findings challenge current beliefs that very short exposures to antenatal steroids before delivery have no effect, and suggest that encouraging the administration of antenatal corticosteroids to pregnant women when delivery is very imminent could result in substantial survival and health gains for very preterm infants,” said Jennifer Zeitlin, French National Institute of Health and Medical Research, Paris, France.
SOURCE: Karolinska Institutet
The findings from the Effective Perinatal Intensive Care in Europe (EPICE) research project suggest that survival and health gains for very preterm infants may occur within hours.
Mikael Norman, MD, Karolinska Institutet, Solna, Sweden, and colleagues have studied outcomes in over 4,500 very preterm infants, born at 24 to 31 weeks of gestation (excluding multiple pregnancies and severe congenital malformations) in 11 countries across Europe.
In this cohort, 15% of the pregnant women were not exposed to antenatal corticosteroids and 21% of the unexposed infants died after birth.
Infants born already 3 hours after corticosteroid administration to the mother had significantly lower mortality than those not exposed to the treatment, and corticosteroid administration 6 to 12 hours before birth was associated with halved risks of infant death.
“Given the current concept of a slow effect, pregnant women at immediate risk of preterm delivery may not receive corticosteroid treatment because it is considered futile,” said Dr. Norman. “Also our results can provide reassurance for clinicians or parents in situations where it is not possible to wait a day or two to reach the full effect of corticosteroid treatment because of the need for action to reduce or stop ongoing morbidity in the pregnant woman and her foetus.”
In the study, antenatal corticosteroid treatment was also associated with a lower risk of severe neonatal morbidity such as bleedings in the brain. This reduction in the risk was associated with longer administration-to-birth intervals.
“Our findings challenge current beliefs that very short exposures to antenatal steroids before delivery have no effect, and suggest that encouraging the administration of antenatal corticosteroids to pregnant women when delivery is very imminent could result in substantial survival and health gains for very preterm infants,” said Jennifer Zeitlin, French National Institute of Health and Medical Research, Paris, France.
SOURCE: Karolinska Institutet
No comments:
Post a Comment