| Abstract | OBJECTIVE: The purpose of this study was to compare the neonatal outcome of 2 approaches to antenatal corticosteroid therapy for threatened preterm delivery in twins: a prophylactic approach in which corticosteroids were administered every 2 weeks from 24 to 32 weeks of gestation and a rescue approach in which corticosteroids were given to women at immediate risk of preterm delivery. STUDY DESIGN: A retrospective cohort study of 1038 twin babies delivered between 1990 and 1996 in a University Teaching Hospital. One hundred thirty-six babies were exposed to prophylactic therapy, and 902 babies were treated expectantly with rescue therapy. RESULTS: Prophylactic corticosteroids were not associated with a significant reduction in respiratory distress syndrome (adjusted odds ratio, 0.7; 95% CI, 0.2-2.0). Unnecessary therapy was more likely with a prophylactic policy (relative risk, 7.5; 95% CI, 5.3-10.7) and was associated with a reduction in mean birth weight in term babies of 129 g (95% CI, -218 to -33; P =.008). CONCLUSION: Prophylactic corticosteroids have no proven beneficial effect on the risk of respiratory distress syndrome in preterm twin babies. Such a policy exposes a large number of babies to unnecessary treatment that adversely affects growth. |
| Authors | Deirdre J Murphy, Sarah Caukwell, Lisa A Joels, P Wardle
(Affiliation: Division of Obstetrics and Gynaecology, St Michael's Hospital, University of Bristol, United Kingdom. d.j.murphy at bristol.ac.uk)
|
| Journal | American journal of obstetrics and gynecology
(Am J Obstet Gynecol)
Vol. 187
Issue 2
Pg. 483-8
(Aug 2002)
ISSN: 0002-9378 United States |
| PMID | 12193947
(Publication Type: Comparative Study, Journal Article)
|
| Chemical References |
- Glucocorticoids
- Dexamethasone
|
| Topics |
- Birth Weight
- Cohort Studies
- Dexamethasone
(administration & dosage)
- Female
- Glucocorticoids
(administration & dosage)
- Humans
- Infant, Newborn
- Male
- Obstetric Labor, Premature
(prevention & control)
- Pregnancy
- Pregnancy Outcome
- Pregnancy, Multiple
(physiology)
- Respiratory Distress Syndrome, Newborn
(prevention & control)
- Retrospective Studies
- Treatment Outcome
- Twins
- Unnecessary Procedures
|
