1. Antenatal corticosteroids and outcomes in gastroschisis: A multicenter retrospective cohort study
- Author
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Carnaghan, Helen, James, Catherine P, Charlesworth, Paul B, Ghionzoli, Marco, Pereira, Susana, Elkhouli, Mohamed, Baud, David, De Coppi, Paolo, Ryan, Greg, Shah, Prakesh S, Davenport, Mark, David, Anna L, Pierro, Agostino, Eaton, Simon, Lapidus-Krol, Eveline, Cross, Kate MK, Kiely, Edward, Patel, Shailesh, Desai, Ashish, Nicolaides, Kypros, Curry, Joseph, and Ade-Ajayi, Niyi
- Subjects
0301 basic medicine ,Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,PRETERM BIRTH ,Gestational Age ,030105 genetics & heredity ,Antenatal steroid ,Cohort Studies ,DELIVERY ,03 medical and health sciences ,AGE ,0302 clinical medicine ,Enteral Nutrition ,Adrenal Cortex Hormones ,Pregnancy ,MANAGEMENT ,Medicine ,Humans ,MULTIPLE COURSES ,Genetics (clinical) ,Retrospective Studies ,Genetics & Heredity ,Gastroschisis ,Fetus ,Science & Technology ,030219 obstetrics & reproductive medicine ,business.industry ,Proportional hazards model ,Hazard ratio ,Infant, Newborn ,Pregnancy Outcome ,Obstetrics & Gynecology ,Obstetrics and Gynecology ,Retrospective cohort study ,Prenatal Care ,Length of Stay ,medicine.disease ,Delivery, Obstetric ,Prognosis ,Treatment Outcome ,Secondary Outcome Measure ,Female ,business ,Life Sciences & Biomedicine ,Cohort study - Abstract
OBJECTIVE: In gastroschisis, there is evidence to suggest that gut dysfunction develops secondary to bowel inflammation; we aimed to evaluate the effect of maternal antenatal corticosteroids administered for obstetric reasons on time to full enteral feeds in a multicenter cohort study of gastroschisis infants. METHODS: A three center, retrospective cohort study (1992-2013) with linked fetal/neonatal gastroschisis data was conducted. The primary outcome measure was time to full enteral feeds (a surrogate measure for bowel function) and secondary outcome measure was length of hospital stay. Analysis included Mann-Whitney and Cox regression. RESULTS: Of 500 patients included in the study, 69 (GA at birth 34 [25-38] weeks) received antenatal corticosteroids and 431 (GA at birth 37 [31-41] weeks) did not. Antenatal corticosteroids had no effect on the rate of reaching full feeds (Hazard ratio HR 1.0 [95% CI: 0.8-1.4]). However, complex gastroschisis (HR 0.3 [95% CI: 0.2-0.4]) was associated with an increased time to reach full feeds and later GA at birth (HR 1.1 per week increase in GA [95% CI: 1.1-1.2]) was associated with a decreased time to reach full feeds. CONCLUSION: Maternal antenatal corticosteroids use, under current antenatal steroid protocols, in gastroschisis is not associated with an improvement in neonatal outcomes such as time to full enteral feeds or length of hospital stay. ispartof: PRENATAL DIAGNOSIS vol:40 issue:8 pages:991-997 ispartof: location:England status: published
- Published
- 2019