Use of antenatal fluorinated corticosteroids in management of congenital heart block: Systematic review and meta-analysis

To evaluate outcomes of fluorinated corticosteroids, with or without other medications, for treatment of congenital heart block in-utero. A search was conducted through MEDLINE, EMBASE, WEB OF SCIENCE and SCOPUS from inception to October 2017. Only comparative studies are considered eligible. Outcom...

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Published in:European journal of obstetrics & gynecology and reproductive biology: X 2019-10, Vol.4, p.100072-100072, Article 100072
Main Authors: Michael, Armia, Radwan, Ahmad A, Ali, Ahmed Kamel, Abd-Elkariem, Ahmed Yassien, Shazly, Sherif A
Format: Article
Language:English
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Review
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Summary:To evaluate outcomes of fluorinated corticosteroids, with or without other medications, for treatment of congenital heart block in-utero. A search was conducted through MEDLINE, EMBASE, WEB OF SCIENCE and SCOPUS from inception to October 2017. Only comparative studies are considered eligible. Outcomes include fetal death, downgrade of heart block, neonatal death, need for neonatal pacing, fetal and maternal complications. Random effects model was used. Out of 923 articles, 12 studies were eligible. Compared to no treatment, there was no significant difference in incidence of fetal death (OR 1.10, 95%CI 0.65-1.84), neonatal death (OR 0.98, 95%CI 0.41-2.33), or need for pacing (OR 1.46, 95%CI 0.78-2.74). Heart block downgrade was significantly higher in treatment group (9.48%vs.1.76%, OR 3.27, 95%CI 1.23-8.71). antenatal fluorinated corticosteroids do not improve fetal/neonatal morbidity or mortality of congenital heart block and are associated with higher incidence of fetal and maternal complications.
ISSN:2590-1613
2590-1613
DOI:10.1016/j.eurox.2019.100072