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Antenatal steroids

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https://www.readbyqxmd.com/read/27918476/antenatal-dexamethasone-exposure-in-preterm-infants-is-associated-with-allergic-diseases-and-the-mental-development-index-in-children
#1
Wan-Ning Tseng, Chih-Cheng Chen, Hong-Ren Yu, Li-Tung Huang, Ho-Chang Kuo
Background: Antenatal steroid administration may benefit fetal lung maturity in preterm infants. Although some studies have shown that this treatment may increase asthma in childhood, the correlation between antenatal dexamethasone exposure and allergic diseases remains unclear. The purpose of this study is to investigate the association between antenatal dexamethasone and T cell expression in childhood allergic diseases. Methods: We recruited a cohort of preterm infants born at Kaohsiung Chang Gung Memorial Hospital between 2007 and 2010 with a gestational age of less than 35 weeks and body weight at birth of less than 1500 g...
December 3, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27881405/effectiveness-of-individualised-lung-recruitment-strategies-at-birth-an-experimental-study-in-preterm-lambs
#2
David G Tingay, Anushi E Rajapaksa, Emanuela Zannin, Prue M Pereira-Fantini, Raffaele Dellacà, Elizabeth Perkins, Cornelis Elroy E Zonneveld, Andy Adler, Don Black, Inez Frerichs, Anna Lavizzari, Magdy Sourial, Bartłomiej Grychtol, Fabio Mosca, Peter G Davis
Respiratory transition at birth involves rapidly clearing fetal lung liquid and preventing efflux back into the lung whilst aeration is established. We have developed a sustained inflation (SIOPT) individualized to volume-response and a dynamic tidal positive end-expiratory pressure (open lung volume, OLV) strategy that both enhance this process. We aimed to compare the effect of each with a group managed with PEEP of 8 cmH2O and no recruitment manoeuvre (No-RM), on gas exchange, lung mechanics, spatiotemporal aeration and lung injury in 127±1d preterm lambs...
November 23, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27834784/lost-in-explanation-lessons-learned-from-audio-recordings-and-surveys-of-the-antenatal-consultation
#3
E M Studer, K L Marc-Aurele
OBJECTIVE: Determine content of antenatal prematurity consultations and identify factors associated with satisfaction. DESIGN: This is an observational study of consultations for possible preterm delivery. Consultations were audio-recorded and analyzed. Parents and physicians were surveyed post-consultation. RESULTS: We analyzed 17 audio-recordings. Mean gestation was 28 weeks. Frequency of topics discussed were: antenatal steroids 82%, intubation 82%, breast milk 76%, time in NICU 65%, development 59%, and survival 53%...
November 9, 2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/27832835/pulmonary-function-at-hospital-discharge-in-preterm-infants-randomized-to-a-single-rescue-course-of-antenatal-steroids
#4
Brian K Jordan, Diane Schilling, Cindy T McEvoy
OBJECTIVE: To compare the pulmonary function, measured at birth and at hospital discharge, of infants whose mothers had been randomized to a single rescue course of antenatal steroids versus those whose mothers had been randomized to placebo. STUDY DESIGN: This study involved follow-up at hospital discharge of subjects of a randomized, double-blinded trial. In the original trial, pregnant women at ≥14 days after their initial course of antenatal steroids and <34 weeks' gestation were randomized to rescue antenatal steroids (44 mothers, 56 infants) or placebo (41 mothers, 57 infants)...
November 7, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27818799/retracted-antenatal-steroid-therapy-for-fetal-lung-maturation-and-the-subsequent-risk-of-childhood-asthma-a-longitudinal-analysis
#5
Journal Of Pregnancy
[This retracts the article DOI: 10.1155/2010/789748.].
2016: Journal of Pregnancy
https://www.readbyqxmd.com/read/27809893/neonatal-mortality-and-morbidity-among-infants-between-24-to-31-complete-weeks-a-multicenter-survey-in-china-from-2013-to-2014
#6
XiangYong Kong, FengDan Xu, Rong Wu, Hui Wu, Rong Ju, XiaoLin Zhao, XiaoMei Tong, HongYan Lv, YanJie Ding, Fang Liu, Ping Xu, WeiPeng Liu, HongBin Cheng, TieQiang Chen, ShuJuan Zeng, WenZheng Jia, ZhanKui Li, HuiXian Qiu, Jin Wang, ZhiChun Feng
BACKGROUND: The outcome of preterm infants has been varied in different hospitals and regions in developing countries. Regular clinical monitor are needed to know the effects of health care. This study aimed to describe the survival and morbidity rates of extreme to very preterm infants in 15 neonatal-intensive care hospitals in China. METHODS: Data were collected from January 1, 2013 to December 31, 2014 for preterm neonates with gestational age (GA) between 24 and 31 complete weeks born in hospitals from our collaborative study group...
November 3, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27742002/prevention-and-management-of-bronchopulmonary-dysplasia-lessons-learned-from-the-neonatal-research-network
#7
Kathleen A Kennedy, C Michael Cotten, Kristi L Watterberg, Waldemar A Carlo
Despite remarkable improvements in survival of extremely premature infants, the burden of BPD among survivors remains a frustrating problem for parents and caregivers. Advances, such as antenatal steroids and surfactant replacement, which have dramatically improved survival, have not reduced BPD among survivors. Other advances that have significantly improved the combined outcome of death or BPD, such as vitamin A and avoidance of mechanical ventilation, have had smaller magnitude effects on the outcome of BPD alone...
October 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27733360/antenatal-corticosteroids-for-maturity-of-term-or-near-term-fetuses-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
Gabriele Saccone, Vincenzo Berghella
OBJECTIVE:  To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN:  Systematic review with meta-analysis. DATA SOURCES:  Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks' gestation...
October 12, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27728915/fetal-and-neonatal-alloimmune-thrombocytopenia-management-and-outcome-of-a-large-international-retrospective-cohort
#9
Marije M Kamphuis, Heidi Tiller, E S van den Akker, Magnus Westgren, Eleonor Tiblad, Dick Oepkes
OBJECTIVE: To evaluate the management and outcome of a large international cohort of cases of pregnancies complicated by fetal and neonatal alloimmune thrombocytopenia (FNAIT). METHODS: This was an observational prospective and retrospective cohort study of all cases of FNAIT entered into the international multicentre No IntraCranial Haemorrhage (NOICH) registry during the period of 2001-2010. We evaluated human platelet antigen (HPA) specificity, the antenatal and postnatal interventions performed, and clinical outcome...
October 12, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27723868/association-of-neurodevelopmental-outcomes-and-neonatal-morbidities-of-extremely-premature-infants-with-differential-exposure-to-antenatal-steroids
#10
Sanjay Chawla, Girija Natarajan, Seetha Shankaran, Athina Pappas, Barbara J Stoll, Waldemar A Carlo, Shampa Saha, Abhik Das, Abbot R Laptook, Rosemary D Higgins
Importance: Many premature infants are born without exposure to antenatal steroids (ANS) or with incomplete courses. This study evaluates the dose-dependent effect of ANS on rates of neonatal morbidities and early childhood neurodevelopmental outcomes of extremely premature infants. Objective: To compare rates of neonatal morbidities and 18- to 22-month neurodevelopmental outcomes of extremely premature infants exposed to no ANS or partial or complete courses of ANS...
December 1, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27693982/prenatal-betamethasone-exposure-and-psychopathology-risk-in-extremely-low-birth-weight-survivors-in-the-third-and-fourth-decades-of-life
#11
Calan Savoy, Mark A Ferro, Louis A Schmidt, Saroj Saigal, Ryan J Van Lieshout
BACKGROUND: Mortality rates among extremely low birthweight (ELBW) infants have declined since the advent of antenatal glucocorticoid use. However, the long term neuropsychiatric effects of exposure are not well understood. We utilized the world's oldest longitudinally followed cohort of ELBW survivors to compare psychopathology over two decades in adulthood in those exposed to prenatal betamethasone and those who were not. METHODS: ELBW survivors (n=179) and matched normal birth weight (NBW) controls (n=145) completed the Young Adult Self-Report questionnaire at 22-26 and 29-36 years, and the Beck Depression and Anxiety Inventories at 29-36 years...
September 28, 2016: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/27690708/characterization-of-mothers-at-risk-of-delivery-at-the-limit-of-viability-and-factors-related-to-infant-survival
#12
Fermín García-Muñoz Rodrigo, José Ángel García Hernández, Alfredo García-Alix
OBJECTIVES: To determine the socio-demographic and clinical characteristics of mothers of infants at the limit of viability, and to know the perinatal factors associated to infants' survival. METHOD: Single center cohort study of mothers and newborns assisted in our tertiary care center (2004-2010). Demographic and perinatal variables were compared between mothers who gave birth ≤26 weeks GA and the general population. The association between perinatal factors and neonatal survival was studied by Cox regression analysis...
October 3, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27668972/antenatal-glucocorticoids-and-neonatal-inflammation-associated-proteins
#13
Maheer Faden, Mari Holm, Elizabeth Allred, Raina Fichorova, Olaf Dammann, Alan Leviton
BACKGROUND: To date, studies of the relationship between antenatal glucocorticoids (AGC) and neonatal inflammation in preterm newborns have been largely limited to umbilical cord blood specimens. AIM: To explore the association between exposure to antenatal glucocorticoids and concentrations of inflammation-related proteins in whole blood collected from very preterm newborns at multiple times during the first postnatal month. METHODS: We measured the protein concentrations on postnatal day 1 (N=1118), day 7 (N=1138), day 14 (N=1030), day 21 (N=936) and day 28 (N=877) from infants born before the 28th week of gestation and explored the relationship between antenatal steroid receipt and protein concentrations in the highest and lowest quartiles...
December 2016: Cytokine
https://www.readbyqxmd.com/read/27651621/respiratory-morbidity-in-late-preterm-births-a-prospective-observational-study-at-a-tertiary-care-hospital
#14
Nazia Shaikh, Shaweez Faizi, Lavanya Rai
OBJECTIVES: To study the neonatal respiratory morbidity in late-preterm neonates. MATERIALS AND METHODS: This study was done over a period of 6 months (November 2014-April 2015) including 120 late-preterm births at a tertiary referral center. RESULTS: Among the 120 late-preterm babies, 42 (35 %) developed respiratory morbidity. Respiratory distress syndrome (RDS) developed in 43 % of the babies who had not received steroid prophylaxis against 25...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27649091/european-consensus-guidelines-on-the-management-of-respiratory-distress-syndrome-2016-update
#15
David G Sweet, Virgilio Carnielli, Gorm Greisen, Mikko Hallman, Eren Ozek, Richard Plavka, Ola Didrik Saugstad, Umberto Simeoni, Christian P Speer, Máximo Vento, Gerard H A Visser, Henry L Halliday
Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe...
September 21, 2016: Neonatology
https://www.readbyqxmd.com/read/27632775/antenatal-steroid-exposure-and-heart-rate-variability-in-adolescents-born-with-very-low-birth-weight
#16
Patricia A Nixon, Lisa K Washburn, Thomas Michael O'Shea, Hossam A Shaltout, Gregory B Russell, Beverly M Snively, James C Rose
BACKGROUND: Reduced heart rate variability (HRV) suggests autonomic imbalance in the control of heart rate and is associated with unfavorable cardiometabolic outcomes. We examined whether antenatal corticosteroid (ANCS) exposure had long-term programming effects on HRV in adolescents born with very low birth weight (VLBW). METHODS: Follow-up study of a cohort of VLBW 14-y olds born between 1992 and 1996 with 50% exposed to ANCS. HRV in both the time and frequency domains using Nevrokard Software was determined from a 5-min electrocardiogram tracing...
October 5, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27627792/early-use-of-inhaled-nitric-oxide-in-preterm-infants-is-there-a-rationale-for-selective-approach
#17
Praveen Chandrasekharan, Rafal Kozielski, Vasantha H S Kumar, Munmun Rawat, Veena Manja, Changxing Ma, Satyan Lakshminrusimha
Inhaled nitric oxide (iNO) is being increasingly used in preterm infants < 34 weeks with hypoxemic respiratory failure (HRF) and/or pulmonary hypertension (PH). Objective To evaluate the risk factors, survival characteristics, and lung histopathology in preterm infants with PH/HRF. Methods Retrospective chart review was conducted to determine characteristics of 93 preterm infants treated with iNO in the first 28 days and compared with 930 matched controls. Factors associated with survival with preterm HRF and smooth muscle actin from nine autopsies were evaluated...
September 14, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27623133/impact-of-targeted-volume-ventilation-on-pulmonary-dynamics-in-preterm-infants-with-respiratory-distress-syndrome
#18
Senem Alkan Ozdemir, Esra Arun Ozer, Ozkan Ilhan, Sumer Sutcuoglu
BACKGROUND: Mechanical ventilation is an essential therapy in the treatment of respiratory failure in preterm infants. However, optimal ventilation strategy continues to be difficult to define. OBJECTIVE: To compare the effects of volume guarantee (VG) combined with intermittent mandatory ventilation (SIMV) and VG combined with pressure support ventilation (PSV) on the pulmonary mechanics and short term prognosis in preterm infants with respiratory distress syndrome...
September 13, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27613336/modeling-the-impact-of-growth-and-leptin-deficits-on-the-neuronal-regulation-of-blood-pressure
#19
Baiba Steinbrekera, Robert D Roghair
The risk of hypertension is increased by intrauterine growth restriction (IUGR) and preterm birth. In the search for modifiable etiologies for this life-threatening cardiovascular morbidity, a number of pathways have been investigated, including excessive glucocorticoid exposure, nutritional deficiency, and aberration in sex hormone levels. As a neurotrophic hormone intimately involved in cardiovascular regulation whose levels are influenced by glucocorticoids, nutritional status and sex hormones, leptin has emerged as a putative etiologic and thus therapeutic agent...
September 9, 2016: Journal of Endocrinology
https://www.readbyqxmd.com/read/27611703/blood-group-a-mothers-are-more-likely-to-develop-anemia-during-antenatal-intravenous-immunoglobulin-treatment-of-fetal-and-neonatal-alloimmune-thrombocytopenia
#20
Madhavi Lakkaraja, Jenny C Jin, Karen C Manotas, Cheryl A Vinograd, Polina Ferd, Julia Gabor, Megan Wissert, Richard L Berkowitz, Janice G McFarland, James B Bussel
BACKGROUND: Incompatibility between parental platelet (PLT) antigens may lead to sensitization of mother and development of fetal and neonatal alloimmune thrombocytopenia (FNAIT) resulting in fetal thrombocytopenia. Intravenous immunoglobulin (IVIG) with or without prednisone is the most effective, evidence-based antenatal treatment for subsequent FNAIT-affected pregnancies. IVIG infusion causes hemolysis in other settings, the degree depending upon patient blood groups (BGs). STUDY DESIGN AND METHODS: In ClinicalTrials...
October 2016: Transfusion
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