Titre :

Efficacy of antenatal corticosteroids in preterm twins: the epipage2 cohort study

Auteur(s) :

Palas, Deborah [Auteur]
Ehlinger, Virginie [Auteur]
Alberge, Corinne I. [Auteur]
Truffert, Patrick [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Kayem, Gilles [Auteur]
Goffinet, François [Auteur]
Ancel, Pierre-Yves [Auteur]
Arnaud, Catherine [Auteur]
Vayssiere, Christophe [Auteur]

Titre de la revue :

BJOG . an international journal of obstetrics and gynaecology

Nom court de la revue :

BJOG

Date de publication :

2017-11-08

ISSN :

1471-0528

Mot(s)-clé(s) en anglais :

short-term morbidity
preterm delivery
Antenatal corticosteroids
twins
twin pregnancy
betamethasone
prematurity
preterm birth
steroid-to-delivery interval

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

OBJECTIVE: To investigate the efficacy of antenatal corticosteroid (ACS) therapy on short-term neonatal outcomes in preterm twins, and further document the influence of the ACS-to-delivery interval. METHODS: EPIPAGE-2 is ...
Lire la suite >OBJECTIVE: To investigate the efficacy of antenatal corticosteroid (ACS) therapy on short-term neonatal outcomes in preterm twins, and further document the influence of the ACS-to-delivery interval. METHODS: EPIPAGE-2 is a nationwide observational multicentre prospective cohort study of neonates born between 22 and 34 completed weeks of gestation. METHODS: All French maternity units, except in a single administrative region, between March and December 2011. METHODS: A total of 750 twin neonates born between 24 and 31 weeks of gestation. METHODS: Exposure to ACSs was examined in four groups: single complete course, with an ACS administration-to-delivery interval of ≤7 days; single complete course, with an ACS-to-delivery interval of >7 days; repeated courses; or no ACS treatment. METHODS: Neonatal outcomes analysed were severe bronchopulmonary dysplasia, periventricular leukomalacia or intraventricular haemorrhage grade III/IV, in-hospital mortality, and a composite indicator of severe outcomes. RESULTS: Compared with no ACSs, in multivariable analysis, a single course of ACSs with an administration-to-delivery interval of ≤7 days was significantly associated with a reduced rate of periventricular leukomalacia or intraventricular haemorrhage grade III/IV (aOR 0.2; CI 95% 0.1-0.5), in-hospital mortality (0.3; 0.1-0.6), and the composite indicator (0.1; 0.1-0.3), whereas a single course of ACDs with an administration-to-delivery interval of >7 days did not significantly reduce the frequency of in-hospital mortality (0.7; 0.3-1.8). No significant differences in terms of benefit or risk were found when comparing repeated courses with a single complete course. CONCLUSIONS: In preterm twins, a single complete course of antenatal corticosteroids was associated with an improvement of severe neurological outcome, whereas reduced in-hospital mortality was seen only when the ACS-to-delivery interval was ≤7 days. A single complete course of antenatal steroids reduced severe neurological morbidity in preterm twins (24-31 weeks).Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2019-12-09T18:18:45Z