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Antenatal steroids

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https://www.readbyqxmd.com/read/29306493/delivery-room-resuscitation-and-short-term-outcomes-in-moderately-preterm-infants
#1
Monika Bajaj, Girija Natarajan, Seetha Shankaran, Myra Wyckoff, Abbot R Laptook, Edward F Bell, Barbara J Stoll, Waldemar A Carlo, Betty R Vohr, Shampa Saha, Krisa P Van Meurs, Pablo J Sanchez, Carl T D'Angio, Rosemary D Higgins, Abhik Das, Nancy Newman, Michele C Walsh
OBJECTIVES: To describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants. STUDY DESIGN: This was an observational cohort study of MPT infants delivered at 290/7 to 336/7 weeks' gestational age (GA) enrolled in the Neonatal Research Network MPT registry. Infants were categorized into 5 groups based on the highest level of delivery room intervention: routine care, oxygen and/or continuous positive airway pressure, bag and mask ventilation, endotracheal intubation, and cardiopulmonary resuscitation including chest compressions and/or epinephrine use...
January 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29305780/corticosteroid-injection-for-an-orthopedic-complaint-in-a-female-with-gestational-diabetes
#2
Palee Myrex, Lorie Harper, Sara Gould
A female with gestational diabetes presented with hip pain characteristic of meralgia paresthetica and trochanteric bursitis. She had similar episodes prior to pregnancy that were treated successfully with non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections. However, NSAID use during pregnancy poses risks to the fetus and corticosteroids carry a risk of hyperglycemia, especially in those with diabetes. Unfortunately, all attempts made to treat her conservatively failed to improve her symptoms...
January 5, 2018: Sports Medicine—Open
https://www.readbyqxmd.com/read/29305231/neurodevelopmental-outcomes-of-infants-born-at-29-weeks-of-gestation-admitted-to-canadian-neonatal-intensive-care-units-based-on-location-of-birth
#3
Reem Amer, Diane Moddemann, Mary Seshia, Ruben Alvaro, Anne Synnes, Kyong-Soon Lee, Shoo K Lee, Prakesh S Shah
OBJECTIVE: To compare mortality and neurodevelopmental outcomes of outborn and inborn preterm infants born at <29 weeks of gestation admitted to Canadian neonatal intensive care units (NICUs). STUDY DESIGN: Data were obtained from the Canadian Neonatal Network and Canadian Neonatal Follow-up Network databases for infants born at <29 weeks of gestation admitted to NICUs from April 2009 to September 2011. Rates of death, severe neurodevelopmental impairment (NDI), and overall NDI were compared between outborn and inborn infants at 18-21 months of age, corrected for prematurity...
January 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29288162/retrospective-consent-in-a-neonatal-randomized-controlled-trial
#4
Nils T Songstad, Calum T Roberts, Brett J Manley, Louise S Owen, Peter G Davis
BACKGROUND AND OBJECTIVES: The requirement for prospective consent in clinical trials in acute settings may result in samples unrepresentative of the study population, potentially altering study findings. However, using retrospective consent may raise ethical issues. We assessed whether using retrospective consent affected recruitment, participant characteristics, and outcomes within a randomized controlled trial. METHODS: We conducted a secondary analysis of a randomized trial, which compared nasal high flow (nHF) with nasal continuous positive airway pressure (CPAP) for primary respiratory support in preterm infants...
December 29, 2017: Pediatrics
https://www.readbyqxmd.com/read/29281936/a-comparative-study-of-hhhfnc-and-ncpap-in-preventing-reintubation-in-extreme-preterm-infants-born-at-less-than-30-week-gestation
#5
W Muhsen, R Roy
INTRODUCTION: Despite recent advances in respiratory support, the wide use of antenatal steroids and surfactant replacement therapy, respiratory problems continue to represent the leading cause of mortality in premature infants during the neonatal period. In the last few years, HHHFNC has been widely adopted as a mode of noninvasive respiratory support for infants with respiratory difficulties. However, data of the safety and efficacy of HHHFNC use in extremely premature infants are scarce...
December 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29279020/short-term-outcomes-comparison-between-preterm-infants-with-and-without-acute-hypoxic-respiratory-failure-attributable-to-presumed-pulmonary-hypoplasia-after-prolonged-preterm-premature-rupture-of-membranes-before-25-gestational-weeks
#6
Ga Young Park, Won Soon Park, Hye Soo Yoo, So Yoon Ahn, Se In Sung, Sung Shin Kim, Yun Sil Chang
OBJECTIVE: To determine the updated outcomes of preterm infants with acute hypoxic respiratory failure attributable to presumed pulmonary hypoplasia (PH) following maternal midtrimester prolonged preterm premature rupture of membranes (PPROM). STUDY DESIGN: Among preterm infants with birthweight < 1500 g and 23-34 weeks gestational age in a single center, infants exposed to maternal prolonged (≥ 7 days) PPROM before 25 gestational weeks (PPPROM25, n = 76) were retrospectively reviewed...
December 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29274832/extremely-preterm-fetal-sheep-lung-responses-to-antenatal-steroids-and-inflammation
#7
Kevin Visconti, Paranthaman Senthamaraikannan, Matthew W Kemp, Masatoshi Saito, Boris W Kramer, John P Newnham, Alan H Jobe, Suhas G Kallapur
BACKGROUND: The efficacy of antenatal steroids for fetal lung maturation in the peri-viable period is not fully understood. OBJECTIVE(S): To determine the lung maturational effects of ANS and inflammation in early gestation sheep fetuses, similar to the peri-viable period in humans. STUDY DESIGN: Date-mated ewes with singleton fetuses were randomly assigned to one of 4 treatment groups (n=8/group): 1) maternal intramuscular injection (IM) of betamethasone (Beta), 2) intra-amniotic lipopolysaccharide (IA) (LPS), 3) Beta+LPS, 4) IA+IM Saline (controls)...
December 21, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29251180/maternal-steroid-therapy-for-fetuses-with-immune-mediated-complete-atrioventricular-block-a-systematic-review-and-meta-analysis
#8
Andrea Ciardulli, Francesco D'Antonio, Elena Rita Magro-Malosso, Gabriele Saccone, Lamberto Manzoli, Mackenzy Radolec, Vincenzo Berghella
INTRODUCTION: To explore the effect of maternal fluorinated steroid therapy on fetuses affected by immune-mediated complete atrio-ventricular block (CAVB) in utero. MATERIAL AND METHODS: Pubmed, Embase, Cinahl and ClinicalTrials.gov databases were searched. Only studies reporting the outcome of fetuses with immune CAVB diagnosed on prenatal ultrasound without any cardiac malformations and treated with fluorinated steroids compared to those not treated were included...
December 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29204094/the-significance-of-il-1%C3%AE-3953c-t-il-6-174g-c-and-596g-a-tnf-%C3%AE-308g-a-gene-polymorphisms-and-86-bp-variable-number-tandem-repeat-polymorphism-of-il-1rn-in-bronchopulmonary-dysplasia-in-infants-born-before-32-weeks-of-gestation
#9
Dawid Szpecht, Janusz Gadzinowski, Irmina Nowak, Dorothy Cygan, Agnieszka Seremak-Mrozikiewicz, Grażyna Kurzawińska, Dariusz Madajczak, Krzysztof Drews, Marta Szymankiewicz
Introduction: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects primarily preterm infants. Genetic factors are also taken into consideration in the pathogenesis of BPD. Genetic predispositions to higher production of inflammation mediators seem to be crucial. Material and methods: The aim of this study was to evaluate the possible relationship between polymorphisms: interleukin-1β +3953 C>T, interleukin-6 -174 G>C and -596 G>A, tumour necrosis factor -308 G>A and interleukin-1RN VNTR 86bp and the occurrence of BPD in a population of 100 preterm infants born from singleton pregnancy, before 32+0 weeks of gestation, exposed to antenatal steroids therapy, and without congenital abnormalities...
2017: Central-European Journal of Immunology
https://www.readbyqxmd.com/read/29185948/pneumopericardium-in-the-neonate
#10
Tiffany L Walker, Dorothy A Shannon
Pneumopericardium occurs when air accumulates in the pericardial sac surrounding the heart and is one of the rarest forms of air leaks in neonates. Because of various advances in neonatal care, including gentler modes of ventilation, surfactant replacement, and antenatal steroids, the incidence of pneumopericardium has decreased. Despite the decrease in incidence of pneumopericardium, most cases arise in premature infants with a history of respiratory distress and mechanical ventilation. Evidence has shown that the incidence is inversely related to birth weight and that pneumopericardium has high mortality and morbidity rates...
November 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/29162660/survival-in-very-preterm-infants-an-international-comparison-of-10-national-neonatal-networks
#11
MULTICENTER STUDY
Kjell Helenius, Gunnar Sjörs, Prakesh S Shah, Neena Modi, Brian Reichman, Naho Morisaki, Satoshi Kusuda, Kei Lui, Brian A Darlow, Dirk Bassler, Stellan Håkansson, Mark Adams, Maximo Vento, Franca Rusconi, Tetsuya Isayama, Shoo K Lee, Liisa Lehtonen
OBJECTIVES: To compare survival rates and age at death among very preterm infants in 10 national and regional neonatal networks. METHODS: A cohort study of very preterm infants, born between 24 and 29 weeks' gestation and weighing <1500 g, admitted to participating neonatal units between 2007 and 2013 in the International Network for Evaluating Outcomes of Neonates. Survival was compared by using standardized ratios (SRs) comparing survival in each network to the survival estimate of the whole population...
December 2017: Pediatrics
https://www.readbyqxmd.com/read/29138038/low-dose-betamethasone-acetate-for-fetal-lung-maturation-in-preterm-sheep
#12
Augusto F Schmidt, Matthew W Kemp, Judith Rittenschober-Böhm, Paranthaman S Kannan, Haruo Usuda, Masatoshi Saito, Lucy Furfaro, Shimpei Watanabe, Sarah Stock, Boris W Kramer, John P Newnham, Suhas G Kallapur, Alan H Jobe
BACKGROUND: Antenatal steroids (ANS) are standard of care for women at risk of preterm delivery; however ANS dosing and formulation have not been adequately evaluated. The standard clinical 2-dose treatment with betamethasone-acetate+betamethasone-phosphate (Beta-P+Beta-Ac) is more effective than 2 doses of Beta-P for inducing lung maturation in preterm fetal sheep. We hypothesized that the slowly-released Beta-Ac component induces similar lung maturation to Beta-P+Beta-Ac with decreased dose and fetal exposure...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29127622/the-joint-effects-of-antenatal-steroids-and-gestational-age-on-improved-outcomes-in-neonates
#13
Neal D Goldstein, Kaitlin M Kenaley, Robert Locke, David A Paul
OBJECTIVES: Antenatal corticosteroids are standard of care for women at risk of a preterm birth and demonstrated to be protective against poor outcomes in neonates including respiratory disorders, mortality and intraventricular hemorrhage (IVH). Its benefits may vary by gestational age, and accurate estimation is needed in a single-center population to account for practice variation. METHODS: A retrospective cohort of infants admitted to the hospital's neonatal intensive care unit, 1997-2015...
November 10, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29091782/ante-peri-and-postnatal-factors-associated-with-intraventricular-hemorrhage-in-very-premature-infants
#14
Martin Poryo, Judith Caroline Boeckh, Ludwig Gortner, Michael Zemlin, Perrine Duppré, Daniel Ebrahimi-Fakhari, Stefan Wagenpfeil, Matthias Heckmann, Eva Mildenberger, Anne Hilgendorff, Andreas W Flemmer, Georg Frey, Sascha Meyer
BACKGROUND: Intraventricular hemorrhage (IVH) is one of the most serious complications in preterm infants and is associated with neurological sequelae and mortality. Over the past few decades, the rate of IVH has decreased due to improved neonatal intensive care. However, up to 15-25% of very and extremely premature infants (<32 and <28weeks of pregnancy (WOP) respectively) still suffer from IVH. STUDY PURPOSE: The aim of this study was to perform an updated, multicenter analysis to identify ante-, peri, and postnatal factors other than gestational age/birth weight associated with IVH of any grade in a large cohort of very and extremely premature infants...
October 26, 2017: Early Human Development
https://www.readbyqxmd.com/read/29082019/antenatal-corticosteroids-for-women-at-risk-of-imminent-preterm-birth-in-low-resource-countries-the-case-for-equipoise-and-the-need-for-efficacy-trials
#15
REVIEW
Joshua P Vogel, Olufemi T Oladapo, Cynthia Pileggi-Castro, Ebunoluwa A Adejuyigbe, Fernando Althabe, Shabina Ariff, Adejumoke Idowu Ayede, Abdullah H Baqui, Anthony Costello, Davy M Chikamata, Caroline Crowther, Bukola Fawole, Luz Gibbons, Alan H Jobe, Monica Lulu Kapasa, John Kinuthia, Alka Kriplani, Oluwafemi Kuti, James Neilson, Janna Patterson, Gilda Piaggio, Rahat Qureshi, Zahida Qureshi, Mari Jeeva Sankar, Jeffrey S A Stringer, Marleen Temmerman, Khalid Yunis, Rajiv Bahl, A Metin Gülmezoglu
The scientific basis for antenatal corticosteroids (ACS) for women at risk of preterm birth has rapidly changed in recent years. Two landmark trials-the Antenatal Corticosteroid Trial and the Antenatal Late Preterm Steroids Trial-have challenged the long-held assumptions on the comparative health benefits and harms regarding the use of ACS for preterm birth across all levels of care and contexts, including resource-limited settings. Researchers, clinicians, programme managers, policymakers and donors working in low-income and middle-income countries now face challenging questions of whether, where and how ACS can be used to optimise outcomes for both women and preterm newborns...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29074512/lung-function-at-term-in-extremely-preterm-born-infants-a-regional-prospective-cohort-study
#16
Mariann Haavik Bentsen, Trond Markestad, Knut Øymar, Thomas Halvorsen
OBJECTIVES: To compare lung function of extremely preterm (EP)-born infants with and without bronchopulmonary dysplasia (BPD) with that of healthy term-born infants, and to determine which perinatal characteristics were associated with lung function at term and how predictive these measurements were for later respiratory health in EP-born infants. METHODS: Perinatal variables were recorded prospectively, and tidal breathing parameters were measured at term-equivalent age using electromagnetic inductance plethysmography...
October 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/29067513/does-antenatal-steroids-treatment-prior-to-elective-cesarean-section-at-34-37%C3%A2-weeks-of-gestation-reduce-neonatal-morbidity-evidence-from-a-case-control-study
#17
Michal Kirshenbaum, Shali Mazaki-Tovi, Uri Amikam, Ram Mazkereth, Eyal Sivan, Eyal Schiff, Yoav Yinon
OBJECTIVE: To determine whether antenatal corticosteroids administration prior to an elective cesarean section (ECS) at 34-37 weeks gestation is associated with improved neonatal outcome. MATERIALS AND METHODS: A case control study of women with singleton pregnancies who underwent ECS between 34 and 37 weeks of gestation including two groups: (1) study group in which patients were treated with betamethasone prior to ECS (n = 58) and (2) control group matched for gestational age at delivery in which patients did not receive betamethasone (n = 107)...
January 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29049359/analysis-of-pd-1-expression-in-the-monocyte-subsets-from-non-septic-and-septic-preterm-neonates
#18
Magdalena Zasada, Marzena Lenart, Magdalena Rutkowska-Zapała, Małgorzata Stec, Wojciech Durlak, Andrzej Grudzień, Agnieszka Krzeczkowska, Nina Mól, Marta Pilch, Maciej Siedlar, Przemko Kwinta
Programmed death-1 (PD-1) receptor system represents a part of recently reported immunoregulatory pathway. PD-1 is an immune checkpoint molecule, which plays an important role in downregulating the immune system proinflammatory activity. Until recently, PD-1 expression was not established on immune cells of the preterm infants. The study objectives were to confirm expression of the PD-1 receptors on the monocytes isolated from very low birth weight newborns (VLBW), and to analyze their expression during the first week of life and late-onset sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/29035425/inhaled-versus-systemic-corticosteroids-for-the-treatment-of-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-infants
#19
REVIEW
Sachin S Shah, Arne Ohlsson, Henry L Halliday, Vibhuti S Shah
BACKGROUND: This is an update of a review published in 2012. A related review "Inhaled versus systemic corticosteroids for preventing bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates" has been updated as well. Bronchopulmonary dysplasia (BPD) is a serious and common problem among very low birth weight infants, despite the use of antenatal steroids and postnatal surfactant therapy to decrease the incidence and severity of respiratory distress syndrome. Due to their anti-inflammatory properties, corticosteroids have been widely used to treat or prevent BPD...
October 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29033349/a-polymorphism-in-the-glucocorticoid-receptor-gene-is-associated-with-refractory-hypotension-in-premature-infants
#20
Kei Ogasawara, Maki Sato, Koichi Hashimoto, Takashi Imamura, Hayato Go, Mitsuaki Hosoya
BACKGROUND: Glucocorticoids play an important role in endocrine control. The association of glucocorticoid receptor (GR) gene polymorphisms with altered sensitivity to glucocorticoid therapy has been reported in adults. However, there are few such reports in infants. The present study analyzed the prevalence of four GR polymorphisms in preterm infants born before 30 weeks of gestation and determined the associations between these polymorphisms and clinical outcomes in the infants. METHODS: Totally, 41 preterm infants born at two hospitals in Fukushima were retrospectively screened for the presence of four GR gene polymorphisms, using a TaqMan single-nucleotide polymorphism genotyping assay...
September 27, 2017: Pediatrics and Neonatology
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