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Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour

Background: A complete course of prenatal corticosteroids reduces the possibility of morbimortality and neonatal respiratory distress syndrome (RDS). Occasionally, it is not possible to initiate or complete the maturation regimen, and the preterm neonate is born in a non-tertiary hospital. This stud...

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Autores principales: Saldaña-García, Natalia, Espinosa-Fernández, María Gracia, Gómez-Robles, Celia, Postigo-Jiménez, Antonio Javier, Bello, Nicholas, Rius-Díaz, Francisca, Sánchez-Tamayo, Tomás
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745219/
https://www.ncbi.nlm.nih.gov/pubmed/35011761
http://dx.doi.org/10.3390/jcm11010020
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author Saldaña-García, Natalia
Espinosa-Fernández, María Gracia
Gómez-Robles, Celia
Postigo-Jiménez, Antonio Javier
Bello, Nicholas
Rius-Díaz, Francisca
Sánchez-Tamayo, Tomás
author_facet Saldaña-García, Natalia
Espinosa-Fernández, María Gracia
Gómez-Robles, Celia
Postigo-Jiménez, Antonio Javier
Bello, Nicholas
Rius-Díaz, Francisca
Sánchez-Tamayo, Tomás
author_sort Saldaña-García, Natalia
collection PubMed
description Background: A complete course of prenatal corticosteroids reduces the possibility of morbimortality and neonatal respiratory distress syndrome (RDS). Occasionally, it is not possible to initiate or complete the maturation regimen, and the preterm neonate is born in a non-tertiary hospital. This study aimed to assess the effects of a single dose of betamethasone within 3 h before delivery on serious outcomes (mortality and serious sequelae) and RDS in preterm neonates born in tertiary vs. non-tertiary hospitals. Materials and methods: Preterm neonates who were <35 weeks and ≤1500 g, treated during a period of five years in a level IIIC NICU, were included in this retrospective cohort study. Participants were divided into groups as follows: NM, non-matured; PM, partial maturation (one dose of betamethasone up to 3 h antepartum). They were further divided based on their place of birth (NICU-IIIC vs. non-tertiary hospitals). The morbimortality rates and the severity of neonatal RDS were evaluated. Results: A total of 76 preterm neonates were included. A decrease in serious outcomes was found in the PM group in comparison to the NM group (OR = 0.2; 95%CI (0.07–0.9)), as well as reduced need for mechanical ventilation (54% vs. 68%). The mean time between maternal admission and birth was similar in both cohorts. The mean time from the administration of betamethasone to delivery was 1 h in the PM cohort. With regard to births in NICU-IIIC, the PM group performed better in terms of serious outcomes (32% vs. 45%) and the duration of mechanical ventilation (117.75 vs. 132.18 h) compared to the NM group. In neonates born in non-tertiary hospitals with PM in comparison to the NM group, a trend towards a reduced serious outcome (28.5% vs. 62.2%) and a decreased need for mechanical ventilation (OR = 0.09; 95%CI (0.01–0.8)) and maximum FiO(2) (p = 0.01) was observed. Conclusions: A single dose of betamethasone up to 3 h antepartum may reduce the rate of serious outcomes and the severity of neonatal RDS, especially in non-tertiary hospitals.
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spelling pubmed-87452192022-01-11 Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour Saldaña-García, Natalia Espinosa-Fernández, María Gracia Gómez-Robles, Celia Postigo-Jiménez, Antonio Javier Bello, Nicholas Rius-Díaz, Francisca Sánchez-Tamayo, Tomás J Clin Med Article Background: A complete course of prenatal corticosteroids reduces the possibility of morbimortality and neonatal respiratory distress syndrome (RDS). Occasionally, it is not possible to initiate or complete the maturation regimen, and the preterm neonate is born in a non-tertiary hospital. This study aimed to assess the effects of a single dose of betamethasone within 3 h before delivery on serious outcomes (mortality and serious sequelae) and RDS in preterm neonates born in tertiary vs. non-tertiary hospitals. Materials and methods: Preterm neonates who were <35 weeks and ≤1500 g, treated during a period of five years in a level IIIC NICU, were included in this retrospective cohort study. Participants were divided into groups as follows: NM, non-matured; PM, partial maturation (one dose of betamethasone up to 3 h antepartum). They were further divided based on their place of birth (NICU-IIIC vs. non-tertiary hospitals). The morbimortality rates and the severity of neonatal RDS were evaluated. Results: A total of 76 preterm neonates were included. A decrease in serious outcomes was found in the PM group in comparison to the NM group (OR = 0.2; 95%CI (0.07–0.9)), as well as reduced need for mechanical ventilation (54% vs. 68%). The mean time between maternal admission and birth was similar in both cohorts. The mean time from the administration of betamethasone to delivery was 1 h in the PM cohort. With regard to births in NICU-IIIC, the PM group performed better in terms of serious outcomes (32% vs. 45%) and the duration of mechanical ventilation (117.75 vs. 132.18 h) compared to the NM group. In neonates born in non-tertiary hospitals with PM in comparison to the NM group, a trend towards a reduced serious outcome (28.5% vs. 62.2%) and a decreased need for mechanical ventilation (OR = 0.09; 95%CI (0.01–0.8)) and maximum FiO(2) (p = 0.01) was observed. Conclusions: A single dose of betamethasone up to 3 h antepartum may reduce the rate of serious outcomes and the severity of neonatal RDS, especially in non-tertiary hospitals. MDPI 2021-12-21 /pmc/articles/PMC8745219/ /pubmed/35011761 http://dx.doi.org/10.3390/jcm11010020 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Saldaña-García, Natalia
Espinosa-Fernández, María Gracia
Gómez-Robles, Celia
Postigo-Jiménez, Antonio Javier
Bello, Nicholas
Rius-Díaz, Francisca
Sánchez-Tamayo, Tomás
Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour
title Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour
title_full Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour
title_fullStr Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour
title_full_unstemmed Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour
title_short Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour
title_sort benefits of a single dose of betamethasone in imminent preterm labour
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745219/
https://www.ncbi.nlm.nih.gov/pubmed/35011761
http://dx.doi.org/10.3390/jcm11010020
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