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Antenatal steroids

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https://www.readbyqxmd.com/read/28735176/reduced-short-term-variation-following-antenatal-administration-of-betamethasone-is-reduced-fetal-size-a-predisposing-factor
#1
Tullio Ghi, Andrea Dall'Asta, Gabriele Saccone, Federica Bellussi, Tiziana Frusca, Pasquale Martinelli, Gianluigi Pilu, Nicola Rizzo
OBJECTIVE: To assess the association between fetal size and the incidence of reduced short-term variability (STV) following bethametasone administration for fetal lung maturity. STUDY DESIGN: This was a retrospective, multicenter, cohort study conducted in two Tertiary University Units. Only uncomplicated singleton pregnancies admitted for threatened preterm labor between 26 and 34 weeks and submitted to betamethasone for fetal lung maturity were included. Delivery occurring within 72h from betamethasone administration represented criteria for exclusion...
July 10, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28666923/allopregnanolone-levels-and-depressive-symptoms-during-pregnancy-in-relation-to-single-nucleotide-polymorphisms-in-the-allopregnanolone-synthesis-pathway
#2
Charlotte Hellgren, Erika Comasco, Alkistis Skalkidou, Inger Sundström-Poromaa
Allopregnanolone, a neurosteroid whose levels rise throughout gestation, putatively stabilizes antenatal mood. The present study aimed to investigate associations of plasma allopregnanolone to antenatal depressive symptoms, as well as to genetic and obstetric factors. Allopregnanolone plasma levels from 284 pregnant women were measured around gestational week 18. Haplotype tag single nucleotide polymorphisms in the aldo-keto reductase family 1, members C2 and C4 (AKR1C2, AKR1C4), and steroid 5 alpha-reductase 1 and 2 (SRD5A1, and SRD5A2) genes were genotyped in a larger sample of pregnant women (n=1351)...
July 20, 2017: Hormones and Behavior
https://www.readbyqxmd.com/read/28665930/kidneys-in-five-year-old-preterm-born-children-a-longitudinal-cohort-monitoring-of-renal-function
#3
Rachel Vieux, Marion Gerard, Audrey Roussel, Aïssata Sow, Amelie Gatin, Francis Guillemin, Jean-Michel Hascoet
BACKGROUND: Knowing the impact of low birth-weight on late onset hypertension, we aimed at: describing systolic blood pressure (sBP) and renal function in 3-5 year-old preterm-born children, and determining which perinatal factors or factors in childhood were associated with an altered renal function at five years in these children. METHODS: Prospective longitudinal cohort study of children born 27-31 weeks gestation included at birth and examined at three, four and five years...
June 30, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28665065/prophylactic-versus-early-rescue-surfactant-treatment-in-preterm-infants-born-at-less-than-30-weeks-gestation-or-with-birth-weight-less-than-or-equal-1-250-grams
#4
Jiyoung Chun, Se In Sung, Yo Han Ho, Jisook Kim, Ga Young Park, Shin Ae Yoon, So Yoon Ahn, Yun Sil Chang, Won Soon Park
Prophylactic surfactant is known to be effective to reduce chronic lung disease in preterm infants compared with rescue surfactant treatment. In Korea, early prophylactic surfactant therapy was introduced in 2011. However, recently, the increased utilization of antenatal steroids and early stabilization through continuous positive airway pressure (CPAP) in the delivery room may have changed the risks and benefits of prophylactic surfactant therapy of infants at high risk of respiratory distress syndrome (RDS)...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28664278/the-significance-of-polymorphisms-in-genes-encoding-il-1%C3%AE-il-6-tnf%C3%AE-and-il-1rn-in-the-pathogenesis-of-intraventricular-hemorrhage-in-preterm-infants
#5
Dawid Szpecht, Janusz Gadzinowski, Agnieszka Seremak-Mrozikiewicz, Grażyna Kurzawińska, Krzysztof Drews, Marta Szymankiewicz
INTRODUCTION: Intraventricular hemorrhage (IVH) is a significant morbidity seen in very low birth weight infants. Genes related to inflammation may be risk factors for IVH. MATERIAL AND METHODS: We examined five polymorphisms for an association with IVH in 100 preterm infants born from singleton pregnancy, before 32 + 0 weeks of gestation, exposed to antenatal steroid therapy, and without congenital abnormalities. These polymorphisms include interleukin-1β 3953 C>T, interleukin-6 -174G>C and -596G>A, tumor necrosis factor -308 G>A, and 86 bp variable number tandem repeat polymorphism of interleukin-1 receptor antagonist (Il -1RN 86 bp VNTR)...
June 29, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28651469/morbidities-associated-with-patent-ductus-arteriosus-in-preterm-infants-nationwide-cohort-study
#6
Pia Härkin, Riitta Marttila, Tytti Pokka, Timo Saarela, Mikko Hallman
PURPOSE: To evaluate the predictive factors for the development of haemodynamically significant patent ductus arteriosus (PDA) in preterm infants and to study the morbidities associated with the treatment of PDA during the first hospitalization. MATERIALS AND METHODS: Data were collected from the Finnish national register of preterm infants (<32 gestational weeks) born in 2005-2013. In total, 3668 infants were included. Morbidities during the first hospitalization were analysed and compared between infants who received treatments for the closure of PDA (n = 1132) and infants who received no treatment for PDA (n = 2536)...
July 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28608944/family-centred-care-right-from-birth-the-irreplaceable-birthday-cuddle
#7
Paul Clarke
Jack, twin 2, was born vaginally at 23+1 weeks' gestation, 576 g. In good condition, despite no antenatal steroids, he was intubated and given surfactant at 3 minutes. After initial stabilisation, the resuscitaire was switched to the portable oxygen cylinder and moved alongside his mother's bed. Jack was then transferred into his mother's arms, still connected to the resuscitaire ventilator system. She was then able to cuddle him for 10-15 minutes while still being ventilated by the attendant neonatologist (Figure 1)...
June 13, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28586580/impact-of-antenatal-corticosteroids-on-frequency-and-mortality-due-to-respiratory-distress-syndrome-in-preterm-neonates
#8
Fazeela Shahzad, Naima Umar
BACKGROUND: Prematurity is still a major problem for health care services throughout the world. Before the late 1980s, respiratory distress syndrome (RDS) was the primary cause of morbidity and mortality in preterm new-borns. Frequency of RDS and ensuing mortality in infants treated with antenatal steroid is less than those delivered without this therapy. Many pregnant females deliver before term or 37 weeks, hence may be advised this prophylactic therapy without creating significant maternal or foetal side effects...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28583707/histologic-chorioamnionitis-and-bronchopulmonary-dysplasia-in-preterm-infants-the-epidemiologic-study-on-low-gestational-ages-2-cohort
#9
Héloïse Torchin, Elsa Lorthe, François Goffinet, Gilles Kayem, Damien Subtil, Patrick Truffert, Louise Devisme, Valérie Benhammou, Pierre-Henri Jarreau, Pierre-Yves Ancel
OBJECTIVE: To investigate the association between histologic chorioamnionitis (HCA) and bronchopulmonary dysplasia (BPD) in very preterm infants, both in a general population and for those born after spontaneous preterm labor and after preterm premature rupture of membranes (pPROM). STUDY DESIGN: This study included 2513 live born singletons delivered at 24-31 weeks of gestation from a national prospective population-based cohort of preterm births; 1731 placenta reports were available...
June 2, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28578635/maternal-hypertension-and-mortality-in-small-for-gestational-age-22-to-29-week-infants
#10
Carole A McBride, Ira M Bernstein, Gary J Badger, Roger F Soll
Infants born before 30 weeks gestational age (GA) to mothers with hypertension (HTN) experience lower rates of mortality and serious morbidities when corrected for maternal and infant characteristics. Growth restriction and maternal HTN are often associated. We sought to determine if small for gestational age (SGA) infants have similarly decreased mortality risk when born to mothers with HTN. We identified 6897 singleton SGA, 22 + 0 to 29 + 6 weeks GA infants born between 2008 and 2011, cared for at 578 North American centers in the Vermont Oxford Network...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28578513/the-role-of-fv-1691g-a-fii-20210g-a-mutations-and-mthfr-677c-t-1298a-c-and-103g-t-fxiii-gene-polymorphisms-in-pathogenesis-of-intraventricular-hemorrhage-in-infants-born-before-32-weeks-of-gestation
#11
Dawid Szpecht, Janusz Gadzinowski, Agnieszka Seremak-Mrozikiewicz, Grażyna Kurzawińska, Krzysztof Drews, Marta Szymankiewicz
BACKGROUND: Congenital thrombophilia is associated with an increased intraventricular hemorrhage (IVH) risk among newborns, but it may also play a protective role. The role of genetic polymorphisms involved in the coagulation pathway of IVH pathogenesis is probably a consequence of an increased risk of thrombosis in the fine blood vessels in the germinal matrix region. MATERIAL AND METHODS: The aim of this study was to evaluate the possible relationship between Factor V (FV) 1691G>A, Factor II (FII) 20210G>A mutations and methylenetetrahydrofolate reductase (MTHFR) 677C>T; 1298A>C and Factor XIII (FXIII) 103G>T gene polymorphisms and the occurrence of IVH in 100 infants born from 24 + 0 to 32 + 0 weeks of gestation, born from singleton pregnancy, before 32 + 0 weeks of gestation, exposed to antenatal steroid therapy, and without congenital abnormalities...
July 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28549589/serum-retinol-levels-and-neonatal-outcomes-in-preterm-infants
#12
Hsing-Jin Chen, Chyong-Hsin Hsu, Bor-Luen Chiang
BACKGROUND: Glucocorticoids are frequently administered to preterm infants, both antenatally and postnatally; however, the effect on serum retinol levels has not been determined. The risk of bronchopulmonary dysplasia is increased in premature infants with low retinol concentrations. OBJECTIVES: Our purpose was to determine the effect of glucocorticoid administration on serum retinol levels in preterm infants. METHODS: All infants <1250 g or <29 weeks' gestation admitted to the neonatal intensive care unit within 48 h of birth were eligible for inclusion...
May 23, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28538237/update-on-postnatal-steroids
#13
Henry L Halliday
Antenatal steroid treatment to enhance fetal lung maturity and surfactant treatment to prevent or treat respiratory distress syndrome have been major advances in perinatal medicine in the past 40 years contributing to improved outcomes for preterm infants. Use of postnatal steroids to prevent or treat chronic lung disease in preterm infants has been less successful and associated with adverse neurodevelopmental outcomes. Although early (in the first week of life) postnatal steroid treatment facilitates earlier extubation and reduces the risk of chronic lung disease, it is associated with adverse effects, such as hyperglycemia, hypertension, gastrointestinal bleeding and perforation, hypertrophic cardiomyopathy, growth failure, and cerebral palsy, and cannot be recommended...
2017: Neonatology
https://www.readbyqxmd.com/read/28538235/what-should-we-do-about-low-blood-pressure-in-preterm-infants
#14
Eugene M Dempsey
The management of preterm infants with low blood pressure soon after birth remains unresolved. The definition of what constitutes low blood pressure is uncertain. At birth, mean blood pressure appears to be gestation specific and increases in the first few days of life. Antenatal steroids, delayed cord clamping, and the avoidance of mechanical ventilation are all associated with higher mean blood pressure and less hypotension after birth. Rates of hypotension of 15-50% have been reported in various studies of extremely preterm infants...
2017: Neonatology
https://www.readbyqxmd.com/read/28528221/bronchopulmonary-dysplasia-and-perinatal-characteristics-predict-1-year-respiratory-outcomes-in-newborns-born-at-extremely-low-gestational-age-a-prospective-cohort-study
#15
Roberta L Keller, Rui Feng, Sara B DeMauro, Thomas Ferkol, William Hardie, Elizabeth E Rogers, Timothy P Stevens, Judith A Voynow, Scarlett L Bellamy, Pamela A Shaw, Paul E Moore
OBJECTIVE: To assess the utility of clinical predictors of persistent respiratory morbidity in extremely low gestational age newborns (ELGANs). STUDY DESIGN: We enrolled ELGANs (<29 weeks' gestation) at ≤7 postnatal days and collected antenatal and neonatal clinical data through 36 weeks' postmenstrual age. We surveyed caregivers at 3, 6, 9, and 12 months' corrected age to identify postdischarge respiratory morbidity, defined as hospitalization, home support (oxygen, tracheostomy, ventilation), medications, or symptoms (cough/wheeze)...
May 17, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28514779/low-back-pain-in-pregnancy-investigations-management-and-role-of-neuraxial-analgesia-and-anaesthesia-a-systematic-review
#16
Herman Sehmbi, Rohan D'Souza, Anuj Bhatia
BACKGROUND: Low back pain (LBP) is commonly experienced during pregnancy and is often poorly managed. There is much ambiguity in diagnostic work-up, appropriate management and decision-making regarding the use of neuraxial analgesia and anaesthesia during labour and delivery in these patients. This systematic review summarises the evidence regarding investigations, management strategies and considerations around performing neuraxial blocks for pregnant women with LBP. METHODS: We searched 3 databases and reviewed literature concerning LBP in pregnancy with regards to diagnostic modalities, management strategies and use of neuraxial techniques for facilitating labour and delivery...
May 18, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28486361/universal-cervical-length-screening-and-antenatal-corticosteroid-timing
#17
Nicole Sahasrabudhe, Catherine Igel, Ghislaine C Echevarria, Peʼer Dar, Diana Wolfe, Peter S Bernstein, Robert Angert, Ashlesha Dayal, Patience Gallagher, Mara Rosner
OBJECTIVE: To evaluate the relationship between universal transvaginal screening for short cervical length in the second trimester and the timing of antenatal corticosteroids. METHODS: We performed a retrospective cohort study of patients with nonanomalous singleton gestations and spontaneous preterm birth between 24 and 34 weeks of gestation after the initiation of a universal transvaginal cervical length screening program between October 2012 and August 2015. Our primary outcome was antenatal corticosteroid administration to a delivery interval of fewer than 7 days...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28455087/assessing-the-potential-impact-of-extending-antenatal-steroids-to-the-late-preterm-period
#18
Vivienne Souter, Ellen Kauffman, Alice J Marshall, Jodie G Katon
BACKGROUND: In 2016, guidance statements were issued by the Society for Maternal-Fetal Medicine and the American Congress of Obstetricians and Gynecologists about extending antenatal steroid use to selected late preterm singleton pregnancies. OBJECTIVE: We sought to review antenatal steroid use prior to the 2016 guidance statements and assess the potential impact of these. STUDY DESIGN: This cohort study used chart-abstracted data from singleton deliveries from Jan...
April 26, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28454696/effect-of-glucocorticoids-on-mechanisms-of-placental-angiogenesis
#19
Aslı Ozmen, Gozde Unek, Emin Turkay Korgun
The benefits of antenatal glucocorticoid (GC) treatment to promote human fetal lung maturation are well established. However, reports have emerged indicating that maternal exposure to high concentrations of circulating GCs alters placental and fetal development. Because many adult-onset metabolic and cardiovascular disorders have their origins in utero, the importance of prenatal conditions should be considered in detail. Therefore, this review aims to present an overview of the GC effect on placental and fetal development, specifically with regard to mechanisms of placental angiogenesis...
April 2017: Placenta
https://www.readbyqxmd.com/read/28436580/pulmonary-function-and-outcomes-in-infants-randomized-to-a-rescue-course-of-antenatal-steroids
#20
Cindy McEvoy, Diane Schilling, Patricia Spitale, Jean O'Malley, Susan Bowling, Manuel Durand
BACKGROUND/OBJECTIVE: Our objective was to obtain follow-up pulmonary function testing and assessment of clinical respiratory outcomes, at 1-2 years, in preterm infants whose mothers were randomized to a single rescue course of antenatal steroids (AS) versus placebo. METHODS: Follow-up of a randomized, double-blinded trial. In the original trial pregnant women ≥14 days after initial course of AS were randomized to rescue AS or placebo. Pulmonary function testing and a standardized respiratory questionnaire were obtained at 1-2 years of corrected age...
April 24, 2017: Pediatric Pulmonology
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