Postnatal Corticosteroids Policy for Very ...
Document type :
Article dans une revue scientifique: Article original
DOI :
PMID :
Permalink :
Title :
Postnatal Corticosteroids Policy for Very Preterm Infants and Bronchopulmonary Dysplasia.
Author(s) :
NUYTTEN, Alexandra [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Behal, Helene [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Duhamel, Alain [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Jarreau, Pierre-Henri [Auteur]
Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique [EPOPé [CRESS - U1153 / UMR_A 1125]]
Torchin, Heloïse [Auteur]
Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique [EPOPé [CRESS - U1153 / UMR_A 1125]]
Milligan, David [Auteur]
Newcastle University [Newcastle]
Maier, Rolf F. [Auteur]
Philipps Universität Marburg = Philipps University of Marburg
Zemlin, Michael [Auteur]
Zeitlin, Jennifer [Auteur]
Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique [CRESS - U1153]
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]
Behal, Helene [Auteur]

METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Duhamel, Alain [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Jarreau, Pierre-Henri [Auteur]
Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique [EPOPé [CRESS - U1153 / UMR_A 1125]]
Torchin, Heloïse [Auteur]
Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique [EPOPé [CRESS - U1153 / UMR_A 1125]]
Milligan, David [Auteur]
Newcastle University [Newcastle]
Maier, Rolf F. [Auteur]
Philipps Universität Marburg = Philipps University of Marburg
Zemlin, Michael [Auteur]
Zeitlin, Jennifer [Auteur]
Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique [CRESS - U1153]
Truffert, Patrick [Auteur]

METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Journal title :
Neonatology
Abbreviated title :
Neonatology
Pages :
1-8
Publication date :
2020-06-06
ISSN :
1661-7819
English keyword(s) :
Postnatal corticosteroids
Bronchopulmonary dysplasia
Very preterm infants
EPICE cohort
Bronchopulmonary dysplasia
Very preterm infants
EPICE cohort
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Introduction: Postnatal corticosteroids (PNC) are effective for reducing bronchopulmonary dysplasia (BPD) in very preterm neonates but are associated with adverse effects including an increased risk of cerebral palsy. PNC ...
Show more >Introduction: Postnatal corticosteroids (PNC) are effective for reducing bronchopulmonary dysplasia (BPD) in very preterm neonates but are associated with adverse effects including an increased risk of cerebral palsy. PNC use in Europe is heterogeneous across regions. This study aimed to assess whether European neonatal intensive care units (NICUs) with a low use of PNC or an explicit policy to reduce PNC use had higher risks of mortality or BPD. Methods: We included 3,126 infants in 105 NICUs born between 24 + 0 and 29 + 6 weeks’ gestational age in 19 regions in 11 countries in the EPICE cohort. First, we identified clusters of NICUs using hierarchical clustering based on PNC use and BPD prevalence and compared case mix and mortality between the clusters. Second, a multilevel analysis was performed to evaluate the association between a restrictive PNC policy and BPD occurrence. Results: There were 3 clusters of NICUs: 52 with low PNC use and a low BPD rate, 37 with low PNC use and a high BPD rate, and 16 with high PNC use and a medium BPD rate. Neonatal mortality did not differ between clusters (p = 0.88). A unit policy of restricted PNC use was not associated with a higher risk of BPD (odds ratio 0.68; 95% confidence interval: 0.45–1.03) after adjustment. Conclusion: Up to 49% of NICUs had low PNC use and low BPD rates, without a difference in mortality. Infants hospitalized in NICUs with a stated policy of low PNC use did not have an increased risk of BPD.Show less >
Show more >Introduction: Postnatal corticosteroids (PNC) are effective for reducing bronchopulmonary dysplasia (BPD) in very preterm neonates but are associated with adverse effects including an increased risk of cerebral palsy. PNC use in Europe is heterogeneous across regions. This study aimed to assess whether European neonatal intensive care units (NICUs) with a low use of PNC or an explicit policy to reduce PNC use had higher risks of mortality or BPD. Methods: We included 3,126 infants in 105 NICUs born between 24 + 0 and 29 + 6 weeks’ gestational age in 19 regions in 11 countries in the EPICE cohort. First, we identified clusters of NICUs using hierarchical clustering based on PNC use and BPD prevalence and compared case mix and mortality between the clusters. Second, a multilevel analysis was performed to evaluate the association between a restrictive PNC policy and BPD occurrence. Results: There were 3 clusters of NICUs: 52 with low PNC use and a low BPD rate, 37 with low PNC use and a high BPD rate, and 16 with high PNC use and a medium BPD rate. Neonatal mortality did not differ between clusters (p = 0.88). A unit policy of restricted PNC use was not associated with a higher risk of BPD (odds ratio 0.68; 95% confidence interval: 0.45–1.03) after adjustment. Conclusion: Up to 49% of NICUs had low PNC use and low BPD rates, without a difference in mortality. Infants hospitalized in NICUs with a stated policy of low PNC use did not have an increased risk of BPD.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Submission date :
2023-11-15T08:47:46Z
2023-12-11T16:22:27Z
2023-12-11T16:22:27Z