Adrenal cortex hormones/therapeutic use Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2015;37(10):467-472
DOI 10.1590/SO100-720320150005440
The administration of a single-course antenatal corticosteroid treatment is recommended for pregnant women between 24 and 34 weeks with risk of premature birth. The maximum effect is achieved when antenatal corticosteroids are administered between 24h and 7 days before delivery. The objective of this study was to evaluate the occurrence of birth within seven days of corticosteroid therapy in major obstetric situations with risk of preterm birth
Retrospective cohort study including 209 pregnant women hospitalized in risk of preterm delivery, submitted to corticosteroid therapy for fetal lung maturation. The study was carried out between January 2012 and March 2014 at a university hospital. Main outcome measure was the number of women who delivered within 7 da ys after antenatal corticosteroid administration. Two groups were defined according to the reason for starting corticosteroids: threatened preterm labour (Group APPT) and other indications for corticosteroid therapy (Group RPPT). A Kaplan-Meier survival analysis was performed and a p value <0.05 was considered statistically significant.
46.4% (n=97) of pregnant women gave birth in the seven days following corticosteroid administration. Delivery within 7 days occurred more frequently on group 2 in comparison to group 1 (57.3 versus42.4%; p=0.001). There is a statistically significant difference between the survival curve for groups 1 and 2, with a hazard ratio for delivery within 7 days 1.71 times higher for group 2 (95%CI 1.23-2.37; p<0.001)
It can be concluded that the probability of an event (birth within 7 days after corticosteroids) is smaller in the group of pregnant women admitted in the context of threatened preterm labor than for other indications. The use of corticosteroids in pregnant women admitted for suspected preterm labor should be subject to rigorous clinical evaluation
Summary
Rev Bras Ginecol Obstet. 2015;37(10):467-472
DOI 10.1590/SO100-720320150005440
The administration of a single-course antenatal corticosteroid treatment is recommended for pregnant women between 24 and 34 weeks with risk of premature birth. The maximum effect is achieved when antenatal corticosteroids are administered between 24h and 7 days before delivery. The objective of this study was to evaluate the occurrence of birth within seven days of corticosteroid therapy in major obstetric situations with risk of preterm birth
Retrospective cohort study including 209 pregnant women hospitalized in risk of preterm delivery, submitted to corticosteroid therapy for fetal lung maturation. The study was carried out between January 2012 and March 2014 at a university hospital. Main outcome measure was the number of women who delivered within 7 da ys after antenatal corticosteroid administration. Two groups were defined according to the reason for starting corticosteroids: threatened preterm labour (Group APPT) and other indications for corticosteroid therapy (Group RPPT). A Kaplan-Meier survival analysis was performed and a p value <0.05 was considered statistically significant.
46.4% (n=97) of pregnant women gave birth in the seven days following corticosteroid administration. Delivery within 7 days occurred more frequently on group 2 in comparison to group 1 (57.3 versus42.4%; p=0.001). There is a statistically significant difference between the survival curve for groups 1 and 2, with a hazard ratio for delivery within 7 days 1.71 times higher for group 2 (95%CI 1.23-2.37; p<0.001)
It can be concluded that the probability of an event (birth within 7 days after corticosteroids) is smaller in the group of pregnant women admitted in the context of threatened preterm labor than for other indications. The use of corticosteroids in pregnant women admitted for suspected preterm labor should be subject to rigorous clinical evaluation
Summary
Rev Bras Ginecol Obstet. 2015;37(9):428-433
DOI 10.1590/SO100-720320150005283
Evaluation of maternal, obstetrics e neonatal features in both spontaneous preterm births (PTB) with or without preterm premature rupture of membranes (PPROM).
Retrospective study of single fetus pregnancies with PTB between 2003 and 2012. Inclusion criteria: PTB associated with ou without PPROM. Exclusion criterias: PTB by medical indication due to fetal/maternal disease and all non accessible or incomplete clinical files. Different characteristics were compared between two groups of PTB: spontaneous PTB without PPROM (sPTB) versus PPROM. Kolmogorov-Smirnov, Levene, χ2, t Student and Mann-Withney tests were used for statistical analysis.
From 2,393 PTB of single fetus, 1,432 files were analysed, from which 596 were sPTB and 836 PPROM. The socioeconomic conditions were similar in both groups. Multiparity (50.7versus 40.3%), personal history of previous PTB (20.8 versus 10.2%), cervical length (18.2 versus 27.2 mm), lower body index mass (23.4 versus 24.3 kg/m2) and higher infectious parameters (Protein C Reactive: 2.2 versus 1.2 mg/L; Leukocytes: 13.3 versus 12.4x109) were more frequent in PBTs (p<0,001). Neonatal outcomes, specially neurologic outcomes (4.7 versus 2.8%, p<0,001), were worst in PBTs.
PTB with or without PPROM has a complex etiology. From all evaluated features in our study, only maternal thinness, multiparity with a previous PTB, the cervical length and worst systemic infections parameters were significant in sPTB. This group also showed worst neonatal outcomes, specially on neurological outcomes.
Summary
Rev Bras Ginecol Obstet. 2015;37(9):428-433
DOI 10.1590/SO100-720320150005283
Evaluation of maternal, obstetrics e neonatal features in both spontaneous preterm births (PTB) with or without preterm premature rupture of membranes (PPROM).
Retrospective study of single fetus pregnancies with PTB between 2003 and 2012. Inclusion criteria: PTB associated with ou without PPROM. Exclusion criterias: PTB by medical indication due to fetal/maternal disease and all non accessible or incomplete clinical files. Different characteristics were compared between two groups of PTB: spontaneous PTB without PPROM (sPTB) versus PPROM. Kolmogorov-Smirnov, Levene, χ2, t Student and Mann-Withney tests were used for statistical analysis.
From 2,393 PTB of single fetus, 1,432 files were analysed, from which 596 were sPTB and 836 PPROM. The socioeconomic conditions were similar in both groups. Multiparity (50.7versus 40.3%), personal history of previous PTB (20.8 versus 10.2%), cervical length (18.2 versus 27.2 mm), lower body index mass (23.4 versus 24.3 kg/m2) and higher infectious parameters (Protein C Reactive: 2.2 versus 1.2 mg/L; Leukocytes: 13.3 versus 12.4x109) were more frequent in PBTs (p<0,001). Neonatal outcomes, specially neurologic outcomes (4.7 versus 2.8%, p<0,001), were worst in PBTs.
PTB with or without PPROM has a complex etiology. From all evaluated features in our study, only maternal thinness, multiparity with a previous PTB, the cervical length and worst systemic infections parameters were significant in sPTB. This group also showed worst neonatal outcomes, specially on neurological outcomes.