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Rescue corticosteroids in twin pregnancies and short‐term neonatal outcomes
Objective To estimate the efficacy of a rescue course of antenatal corticosteroids in twin pregnancies. Design Retrospective cohort study. Setting Tertiary‐care centre. Population Twins born from 24 to 21% (6.3 ± 4.3 versus 33.3 ± 25.8 days, P = 0.003), a lower incidence of mechanical ventilatio...
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| Published in: | BJOG : an international journal of obstetrics and gynaecology 2013-01, Vol.120 (1), p.58-63 |
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| container_title | BJOG : an international journal of obstetrics and gynaecology |
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| creator | Bibbo, C Deluca, L Gibbs, KA Saltzman, DH Rebarber, A Green, RS Fox, NS |
| description | Objective To estimate the efficacy of a rescue course of antenatal corticosteroids in twin pregnancies.
Design Retrospective cohort study.
Setting Tertiary‐care centre.
Population Twins born from 24 to 21% (6.3 ± 4.3 versus 33.3 ± 25.8 days, P = 0.003), a lower incidence of mechanical ventilation >14 days or death while on mechanical ventilation (0 versus 12.5%, P = 0.016), and a lower incidence of retinopathy of prematurity (0 versus 12.5%, P = 0.016). The proportion of neonates with respiratory distress syndrome did not differ between the groups (adjusted odds ratio 1.28, 95% confidence interval 0.50–3.26). There were no differences found for birthweight, head circumference and length.
Conclusions In twins born before 34 weeks of gestation, exposure to rescue corticosteroids may be associated with improved neonatal outcomes. Further studies are warranted to assess the effect of rescue corticosteroids in twin pregnancies. |
| doi_str_mv | 10.1111/1471-0528.12021 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1239059651</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1239059651</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4011-358de71d669fe720a24e4e7fb9063c8d2289fc1d71eae061d34b7b6a69b901d63</originalsourceid><addsrcrecordid>eNqFkMtKxDAUhoMo3tfupCCCm445SZu0Sx28MiKIrkMmPdVK24xJi7jzEXxGn8R0ZlRwYxZJCN_58_MRsgd0BGEdQyIhpinLRsAogxWy-fOyOr_TmHKWbZAt758pBcEoXycbjAMDyPJNcnOH3vQYGeu6yljfobNV4aOqjbrXsM0cPra6NRX6SLdF5J8C-Pn-EbgmatG2utN1ZPvO2Ab9Dlkrde1xd3luk4fzs_vxZTy5vbgan0xik1CAmKdZgRIKIfISJaOaJZigLKc5FdxkBWNZXhooJKBGKqDgyVROhRZ5IMIY3yZHi9yZsy89-k41lTdY1zpU6r0CxnOa5iKFgB78QZ9t79rQbqCk4ILBEHi8oIyz3jss1cxVjXZvCqgaTKvBqxq8qrnpMLG_zO2nDRY__LfaABwuAe2Nrks3WPS_nJApyHnBdMG9VjW-_fevOr2-XRT4AoAzlME</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1237636216</pqid></control><display><type>article</type><title>Rescue corticosteroids in twin pregnancies and short‐term neonatal outcomes</title><source>Wiley</source><creator>Bibbo, C ; Deluca, L ; Gibbs, KA ; Saltzman, DH ; Rebarber, A ; Green, RS ; Fox, NS</creator><creatorcontrib>Bibbo, C ; Deluca, L ; Gibbs, KA ; Saltzman, DH ; Rebarber, A ; Green, RS ; Fox, NS</creatorcontrib><description>Objective To estimate the efficacy of a rescue course of antenatal corticosteroids in twin pregnancies.
Design Retrospective cohort study.
Setting Tertiary‐care centre.
Population Twins born from 24 to <34 weeks of gestation in a single maternal and fetal medicine practice from 2006 to 2011.
Methods We compared neonatal outcomes in 88 twins exposed to a single course of corticosteroids with outcomes in 42 twins exposed to two courses of corticosteroids: the initial course and a single rescue course. Analyses were adjusted to control for correlation between twins born to the same mother.
Main outcome measure Short‐term neonatal respiratory morbidity.
Results Rescue corticosteroids were associated with fewer days of mechanical ventilation (7.3 ± 3.3 versus 33.9 ± 25.3 days, P = 0.003), fewer days with a fraction of inspired oxygen of >21% (6.3 ± 4.3 versus 33.3 ± 25.8 days, P = 0.003), a lower incidence of mechanical ventilation >14 days or death while on mechanical ventilation (0 versus 12.5%, P = 0.016), and a lower incidence of retinopathy of prematurity (0 versus 12.5%, P = 0.016). The proportion of neonates with respiratory distress syndrome did not differ between the groups (adjusted odds ratio 1.28, 95% confidence interval 0.50–3.26). There were no differences found for birthweight, head circumference and length.
Conclusions In twins born before 34 weeks of gestation, exposure to rescue corticosteroids may be associated with improved neonatal outcomes. Further studies are warranted to assess the effect of rescue corticosteroids in twin pregnancies.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.12021</identifier><identifier>PMID: 23121189</identifier><identifier>CODEN: BIOGFQ</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adrenal Cortex Hormones - therapeutic use ; Biological and medical sciences ; Bones, joints and connective tissue. Antiinflammatory agents ; Corticosteroids ; Drug therapy ; Female ; Gestational Age ; Gynecology. Andrology. Obstetrics ; Humans ; Infant, Newborn ; Male ; Medical sciences ; Neonatal care ; outcomes ; Perinatal Care - methods ; Pharmacology. Drug treatments ; Pregnancy ; Pregnancy, Twin ; Premature Birth - drug therapy ; preterm birth ; rescue ; Respiration, Artificial ; Respiratory Distress Syndrome, Newborn - prevention & control ; Respiratory system ; Respiratory System Agents - therapeutic use ; Retrospective Studies ; twin ; Twins</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2013-01, Vol.120 (1), p.58-63</ispartof><rights>2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG</rights><rights>2014 INIST-CNRS</rights><rights>2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4011-358de71d669fe720a24e4e7fb9063c8d2289fc1d71eae061d34b7b6a69b901d63</citedby><cites>FETCH-LOGICAL-c4011-358de71d669fe720a24e4e7fb9063c8d2289fc1d71eae061d34b7b6a69b901d63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26751751$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23121189$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bibbo, C</creatorcontrib><creatorcontrib>Deluca, L</creatorcontrib><creatorcontrib>Gibbs, KA</creatorcontrib><creatorcontrib>Saltzman, DH</creatorcontrib><creatorcontrib>Rebarber, A</creatorcontrib><creatorcontrib>Green, RS</creatorcontrib><creatorcontrib>Fox, NS</creatorcontrib><title>Rescue corticosteroids in twin pregnancies and short‐term neonatal outcomes</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>Objective To estimate the efficacy of a rescue course of antenatal corticosteroids in twin pregnancies.
Design Retrospective cohort study.
Setting Tertiary‐care centre.
Population Twins born from 24 to <34 weeks of gestation in a single maternal and fetal medicine practice from 2006 to 2011.
Methods We compared neonatal outcomes in 88 twins exposed to a single course of corticosteroids with outcomes in 42 twins exposed to two courses of corticosteroids: the initial course and a single rescue course. Analyses were adjusted to control for correlation between twins born to the same mother.
Main outcome measure Short‐term neonatal respiratory morbidity.
Results Rescue corticosteroids were associated with fewer days of mechanical ventilation (7.3 ± 3.3 versus 33.9 ± 25.3 days, P = 0.003), fewer days with a fraction of inspired oxygen of >21% (6.3 ± 4.3 versus 33.3 ± 25.8 days, P = 0.003), a lower incidence of mechanical ventilation >14 days or death while on mechanical ventilation (0 versus 12.5%, P = 0.016), and a lower incidence of retinopathy of prematurity (0 versus 12.5%, P = 0.016). The proportion of neonates with respiratory distress syndrome did not differ between the groups (adjusted odds ratio 1.28, 95% confidence interval 0.50–3.26). There were no differences found for birthweight, head circumference and length.
Conclusions In twins born before 34 weeks of gestation, exposure to rescue corticosteroids may be associated with improved neonatal outcomes. Further studies are warranted to assess the effect of rescue corticosteroids in twin pregnancies.</description><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>Corticosteroids</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neonatal care</subject><subject>outcomes</subject><subject>Perinatal Care - methods</subject><subject>Pharmacology. Drug treatments</subject><subject>Pregnancy</subject><subject>Pregnancy, Twin</subject><subject>Premature Birth - drug therapy</subject><subject>preterm birth</subject><subject>rescue</subject><subject>Respiration, Artificial</subject><subject>Respiratory Distress Syndrome, Newborn - prevention & control</subject><subject>Respiratory system</subject><subject>Respiratory System Agents - therapeutic use</subject><subject>Retrospective Studies</subject><subject>twin</subject><subject>Twins</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNqFkMtKxDAUhoMo3tfupCCCm445SZu0Sx28MiKIrkMmPdVK24xJi7jzEXxGn8R0ZlRwYxZJCN_58_MRsgd0BGEdQyIhpinLRsAogxWy-fOyOr_TmHKWbZAt758pBcEoXycbjAMDyPJNcnOH3vQYGeu6yljfobNV4aOqjbrXsM0cPra6NRX6SLdF5J8C-Pn-EbgmatG2utN1ZPvO2Ab9Dlkrde1xd3luk4fzs_vxZTy5vbgan0xik1CAmKdZgRIKIfISJaOaJZigLKc5FdxkBWNZXhooJKBGKqDgyVROhRZ5IMIY3yZHi9yZsy89-k41lTdY1zpU6r0CxnOa5iKFgB78QZ9t79rQbqCk4ILBEHi8oIyz3jss1cxVjXZvCqgaTKvBqxq8qrnpMLG_zO2nDRY__LfaABwuAe2Nrks3WPS_nJApyHnBdMG9VjW-_fevOr2-XRT4AoAzlME</recordid><startdate>201301</startdate><enddate>201301</enddate><creator>Bibbo, C</creator><creator>Deluca, L</creator><creator>Gibbs, KA</creator><creator>Saltzman, DH</creator><creator>Rebarber, A</creator><creator>Green, RS</creator><creator>Fox, NS</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201301</creationdate><title>Rescue corticosteroids in twin pregnancies and short‐term neonatal outcomes</title><author>Bibbo, C ; Deluca, L ; Gibbs, KA ; Saltzman, DH ; Rebarber, A ; Green, RS ; Fox, NS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4011-358de71d669fe720a24e4e7fb9063c8d2289fc1d71eae061d34b7b6a69b901d63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>Corticosteroids</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neonatal care</topic><topic>outcomes</topic><topic>Perinatal Care - methods</topic><topic>Pharmacology. Drug treatments</topic><topic>Pregnancy</topic><topic>Pregnancy, Twin</topic><topic>Premature Birth - drug therapy</topic><topic>preterm birth</topic><topic>rescue</topic><topic>Respiration, Artificial</topic><topic>Respiratory Distress Syndrome, Newborn - prevention & control</topic><topic>Respiratory system</topic><topic>Respiratory System Agents - therapeutic use</topic><topic>Retrospective Studies</topic><topic>twin</topic><topic>Twins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bibbo, C</creatorcontrib><creatorcontrib>Deluca, L</creatorcontrib><creatorcontrib>Gibbs, KA</creatorcontrib><creatorcontrib>Saltzman, DH</creatorcontrib><creatorcontrib>Rebarber, A</creatorcontrib><creatorcontrib>Green, RS</creatorcontrib><creatorcontrib>Fox, NS</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bibbo, C</au><au>Deluca, L</au><au>Gibbs, KA</au><au>Saltzman, DH</au><au>Rebarber, A</au><au>Green, RS</au><au>Fox, NS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rescue corticosteroids in twin pregnancies and short‐term neonatal outcomes</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2013-01</date><risdate>2013</risdate><volume>120</volume><issue>1</issue><spage>58</spage><epage>63</epage><pages>58-63</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><coden>BIOGFQ</coden><abstract>Objective To estimate the efficacy of a rescue course of antenatal corticosteroids in twin pregnancies.
Design Retrospective cohort study.
Setting Tertiary‐care centre.
Population Twins born from 24 to <34 weeks of gestation in a single maternal and fetal medicine practice from 2006 to 2011.
Methods We compared neonatal outcomes in 88 twins exposed to a single course of corticosteroids with outcomes in 42 twins exposed to two courses of corticosteroids: the initial course and a single rescue course. Analyses were adjusted to control for correlation between twins born to the same mother.
Main outcome measure Short‐term neonatal respiratory morbidity.
Results Rescue corticosteroids were associated with fewer days of mechanical ventilation (7.3 ± 3.3 versus 33.9 ± 25.3 days, P = 0.003), fewer days with a fraction of inspired oxygen of >21% (6.3 ± 4.3 versus 33.3 ± 25.8 days, P = 0.003), a lower incidence of mechanical ventilation >14 days or death while on mechanical ventilation (0 versus 12.5%, P = 0.016), and a lower incidence of retinopathy of prematurity (0 versus 12.5%, P = 0.016). The proportion of neonates with respiratory distress syndrome did not differ between the groups (adjusted odds ratio 1.28, 95% confidence interval 0.50–3.26). There were no differences found for birthweight, head circumference and length.
Conclusions In twins born before 34 weeks of gestation, exposure to rescue corticosteroids may be associated with improved neonatal outcomes. Further studies are warranted to assess the effect of rescue corticosteroids in twin pregnancies.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>23121189</pmid><doi>10.1111/1471-0528.12021</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 1470-0328 |
| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2013-01, Vol.120 (1), p.58-63 |
| issn | 1470-0328 1471-0528 |
| language | eng |
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| source | Wiley |
| subjects | Adrenal Cortex Hormones - therapeutic use Biological and medical sciences Bones, joints and connective tissue. Antiinflammatory agents Corticosteroids Drug therapy Female Gestational Age Gynecology. Andrology. Obstetrics Humans Infant, Newborn Male Medical sciences Neonatal care outcomes Perinatal Care - methods Pharmacology. Drug treatments Pregnancy Pregnancy, Twin Premature Birth - drug therapy preterm birth rescue Respiration, Artificial Respiratory Distress Syndrome, Newborn - prevention & control Respiratory system Respiratory System Agents - therapeutic use Retrospective Studies twin Twins |
| title | Rescue corticosteroids in twin pregnancies and short‐term neonatal outcomes |
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