Title :

Impact of prenatal corticosteroid therapy on sickle cell disease in pregnant women.

Author(s) :

Wang, Florence [Auteur]
Hôpital Louis Mourier - AP-HP [Colombes]
Mandelbrot, Laurent [Auteur]
Hôpital Louis Mourier - AP-HP [Colombes]
Affo, Louis [Auteur]
Hôpital Louis Mourier - AP-HP [Colombes]
Galacteros, Frédéric [Auteur]
CHU Henri Mondor [Créteil]
Bounan, Stéphane [Auteur]
Centre Hospitalier de Saint-Denis [Ile-de-France]
Fernandez, Hervé [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Fichez, Axel [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Cannas, Giovanna [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Driessen, Marine [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Debarge, Veronique [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Loko, Gylna [Auteur]
Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique]
Gnofam, Mayi [Auteur]
Hôpital Louis Mourier - AP-HP [Colombes]
Makowski, Caroline [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Graesslin, Olivier [Auteur]
Hôpital Maison Blanche
Haddad, Bassam [Auteur]
Centre Hospitalier Intercommunal de Créteil [CHIC]
Sibiude, Jeanne [Auteur]
Hôpital Louis Mourier - AP-HP [Colombes]

Journal title :

International Journal of Gynecology and Obstetrics

Abbreviated title :

Int J Gynaecol Obstet

Publication date :

2023-05-13

ISSN :

1879-3479

English keyword(s) :

vaso-occlusive crisis
sickle cell disease
preterm birth
prenatal corticosteroids
pregnancy

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective To evaluate safety of prenatal corticosteroids in pregnancies of women with sickle cell disease. Methods A multicenter observational study of patients with sickle cell disease, comparing vaso-occlusive ...
Show more >Objective To evaluate safety of prenatal corticosteroids in pregnancies of women with sickle cell disease. Methods A multicenter observational study of patients with sickle cell disease, comparing vaso-occlusive crises (VOC) requiring hospital care between pregnancies with versus without prenatal corticosteroids. Results In 40 pregnancies exposed to prenatal corticosteroids, compared with 370 unexposed pregnancies, VOC were not more frequent (62.5% vs 57.9%, P = 0.578) but they were more severe, with more intensive care hospitalizations (25.0% vs 12.9%, P = 0.039), emergency transfusions (44.7% vs 22.7%, P = 0.006), and acute chest syndromes (22.5% vs 8.9%, P = 0.010). These differences persisted after adjustment for severity and type of sickle cell syndrome (for intensive care admission adjusted odds ratio [aOR] 2.73, 95% confidence interval [CI] 1.10–6.79, P = 0.031 and for acute chest syndrome aOR 4.15, 95% CI 1.57–14.4, P = 0.008). VOC occurred on average 1.2 days following steroid administration. When comparing 36 patients receiving corticosteroids for fetal maturation with 58 patients who were hospitalized for obstetrical complications before 34 weeks of pregnancy but that did not receive corticosteroids, VOC incidence was not significantly higher (41.7% vs 31.5%, P = 0.323). Conclusion The present study was the first to study the impact of prenatal corticosteroids on sickle cell disease. They were associated with more severe VOC, suggesting that steroids should be avoided in these women.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

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

Submission date :

2023-11-15T02:02:41Z
2024-04-04T09:35:12Z