European guidelines on perinatal care: corticosteroids for women at risk of preterm birth.

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European guidelines on perinatal care: corticosteroids for women at risk of preterm birth.

Daskalakis, George (författare): 1st department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece

Pergialiotis, Vasilios (författare): 1st department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece

Domellöf, Magnus, 1963- (författare): Umeå universitet,Pediatrik

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Ehrhardt, Harald (författare): Department of General Pediatrics and Neonatology, Justus-Liebig-University and Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany; German Lung Research Center (DZL), Giessen, Germany; Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany

Di Renzo, Gian Carlo (författare): Center for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy; PREIS International and European School of Perinatal, Neonatal and Reproductive Medicine, Florence, Italy; Department of Obstetrics and Gynecology, I.M. Sechenov First State University of Moscow, Moscow, Russian Federation

Koç, Esin (författare): Department of Neonatology, Gazi University, Faculty of Medicine, Ankara, Turkey

Malamitsi-Puchner, Ariadne (författare): Neonatal Intensive Care Unit, 3rd Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece

Kacerovsky, Marian (författare): Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Králové, Hradec Kralove, Czech Republic

Modi, Neena (författare): Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom; Chelsea and Westminster NHS Foundation Trust, London, United Kingdom

Shennan, Andrew (författare): Department of Women and Children’s Health, King’s College London, London, United Kingdom

Ayres-de-Campos, Diogo (författare): Medical School, Santa Maria University Hospital, Lisbon, Portugal; European Board and College of Obstetrics and Gynaecology, Brussels, Belgium

Gliozheni, Elko (författare): Department of Obstetrics and Gynaecology, Maternity Koco Gliozheni Hospital, Tirana, Albania

Rull, Kristiina (författare): Women’s Clinic of Tartu University Hospital, Tartu, Estonia; Department of Obstetrics and Gynaecology, University of Tartu, Tartu, Estonia; Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia

Braun, Thorsten (författare): Department of Obstetrics and Division of ‘Experimental Obstetrics’, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany

Beke, Artur (författare): Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary

Kosińska-Kaczyńska, Katarzyna (författare): Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, Warsaw, Poland

Areia, Ana Luisa (författare): Obstetrics Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Centre of Investigation in Environment, Genetics and Oncobiology (CIMAGO), Coimbra, Portugal

Vladareanu, Simona (författare): Neonatology Clinic, Department of Obstetrics and Gynecology, Faculty of General Medicine, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

Sršen, Tanja Premru (författare): Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Medical Faculty, University of Ljubljana, Ljubljana, Slovenia

Schmitz, Thomas (författare): Department of Obstetrics and Gynecology, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Service de gynécologie-obstétrique, hôpital Robert-Debré, Université Paris Cité, Paris, France

Jacobsson, Bo, 1960 (författare): Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway

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2023-01-23
2023
Engelska.
Ingår i: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. - : Informa UK Limited. - 1476-4954 .- 1476-7058. ; 36:1

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

of recommendationsCorticosteroids should be administered to women at a gestational age between 24+0 and 33+6weeks, when preterm birth is anticipated in the next seven days, as these have been consistently shown to reduce neonatal mortality and morbidity. (Strong-quality evidence; strong recommendation). In selected cases, extension of this period up to 34+6weeks may be considered (Expert opinion). Optimal benefits are found in infants delivered within 7days of corticosteroid administration. Even a single-dose administration should be given to women with imminent preterm birth, as this is likely to improve neurodevelopmental outcome (Moderate-quality evidence; conditional recommendation).Either betamethasone (12mg administered intramuscularly twice, 24-hours apart) or dexamethasone (6mg administered intramuscularly in four doses, 12-hours apart, or 12mg administered intramuscularly twice, 24-hours apart), may be used (Moderate-quality evidence; Strong recommendation). Administration of two "all" doses is named a "course of corticosteroids".Administration between 22+0 and 23+6weeks should be considered when preterm birth is anticipated in the next seven days and active newborn life-support is indicated, taking into account parental wishes. Clear survival benefit has been observed in these cases, but the impact on short-term neurological and respiratory function, as well as long-term neurodevelopmental outcome is still unclear (Low/moderate-quality evidence; Weak recommendation).Administration between 34+0 and 34+6weeks should only be offered to a few selected cases (Expert opinion). Administration between 35+0 and 36+6weeks should be restricted to prospective randomized trials. Current evidence suggests that although corticosteroids reduce the incidence of transient tachypnea of the newborn, they do not affect the incidence of respiratory distress syndrome, and they increase neonatal hypoglycemia. Long-term safety data are lacking (Moderate quality evidence; Conditional recommendation).Administration in pregnancies beyond 37+0weeks is not indicated, even for scheduled cesarean delivery, as current evidence does not suggest benefit and the long-term effects remain unknown (Low-quality evidence; Conditional recommendation).Administration should be given in twin pregnancies, with the same indication and doses as for singletons. However, existing evidence suggests that it should be reserved for pregnancies at high-risk of delivering within a 7-day interval (Low-quality evidence; Conditional recommendation). Maternal diabetes mellitus is not a contraindication to the use of antenatal corticosteroids (Moderate quality evidence; Strong recommendation).A single repeat course of corticosteroids can be considered in pregnancies at less than 34+0weeks gestation, if the previous course was completed more than seven days earlier, and there is a renewed risk of imminent delivery (Low-quality evidence; Conditional recommendation).

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)

Nyckelord

Infant
Child
Female
Infant
Newborn
Pregnancy
Humans
Young Adult
Adult
Premature Birth
Perinatal Care
Prospective Studies
Adrenal Cortex Hormones
Betamethasone
antenatal

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