Association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants: a multicentre cohort study
Objectives To determine the dose-dependent associations between antenatal corticosteroids (ANS) exposure and the rates of major morbidities, and the early weight loss percentage (EWLP) in hospital among extremely preterm infants (EPI) or extremely low birthweight infants (ELBWI).Methods A multicentr...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-05-01
|
| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/8/1/e002506.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849389796207624192 |
|---|---|
| author | Ying Zhou Qi Feng Haijun Wang Wei Guo Xiaofang Huang Xiuying Tian Yong Ji Shuaijun Li Shufen Zhai Rongxiu Zheng |
| author_facet | Ying Zhou Qi Feng Haijun Wang Wei Guo Xiaofang Huang Xiuying Tian Yong Ji Shuaijun Li Shufen Zhai Rongxiu Zheng |
| author_sort | Ying Zhou |
| collection | DOAJ |
| description | Objectives To determine the dose-dependent associations between antenatal corticosteroids (ANS) exposure and the rates of major morbidities, and the early weight loss percentage (EWLP) in hospital among extremely preterm infants (EPI) or extremely low birthweight infants (ELBWI).Methods A multicentre, retrospective cohort study of EPI or ELBWI born between 2017 and 2018 was conducted. Infants were classified into no ANS, partial ANS and complete ANS exposure group; three subgroups were generated by gestational age and birth weight. Multiple logistic regression and multiple linear regression were performed.Results There were 725 infants included from 32 centres. Among no ANS, partial ANS and complete ANS exposure, there were significant differences in the proportions of bronchopulmonary dysplasia (BPD) (24.5%, 25.4% and 16.1%), necrotising enterocolitis (NEC) (6.7%, 2.0% and 2.0%) and death (29.6%, 18.5% and 13.5%), and insignificant differences in the proportions of intraventricular haemorrhage (IVH) (12.5%, 13.2% and 12.2%), and extrauterine growth restriction (EUGR) (50.0%, 56.6% and 59.5%). In the logistic regression, compared with no ANS exposure, complete ANS reduced the risk of BPD (OR 0.58, 95% CI 0.37 to 0.91), NEC (OR 0.21, 95% CI 0.08 to 0.57) and death (OR 0.36, 95% CI 0.23 to 0.56), and partial ANS reduced the risk of NEC (OR 0.23, 95% CI 0.07 to 0.72) and death (OR 0.54, 95% CI 0.34 to 0.87). Compared with partial ANS exposure, complete ANS decreased the risk of BPD (OR 0.58, 95% CI 0.37 to 0.91). There were insignificant associations between ANS exposure and IVH, EUGR. In the multiple linear regression, partial and complete ANS exposure increased EWLP only in the ≥28 weeks (w) and <1000 g subgroup (p<0.05).Conclusions Different doses of ANS (dexamethasone) exposure were protectively associated with BPD, NEC, death in hospital, but not EUGR at discharge among EPI or ELBWI. Beneficial dose-dependent associations between ANS (dexamethasone) exposure and BPD existed. ANS exposure increased EWLP only in the ≥28 w and<1000 g subgroup. ANS administration, especially complete ANS, is encouraged before preterm birth.Trial registration number NCT06082414. |
| format | Article |
| id | doaj-art-4c8809c509ec42c5a15038f6b42d1502 |
| institution | Kabale University |
| issn | 2399-9772 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj-art-4c8809c509ec42c5a15038f6b42d15022025-08-20T03:41:51ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722024-05-018110.1136/bmjpo-2024-002506Association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants: a multicentre cohort studyYing Zhou0Qi Feng1Haijun Wang2Wei Guo3Xiaofang Huang4Xiuying Tian5Yong Ji6Shuaijun Li7Shufen Zhai8Rongxiu Zheng9Department of Pediatrics, Peking University Third Hospital, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaDepartment of Maternal and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Peking University School of Public Health, Beijing, ChinaBeijing Key Laboratory of Cancer Invasion and Metastasis Research, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaDepartment of Neonatology, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, ChinaNeonatal Intensive Care Unit, Children’s Hospital of Shanxi, Taiyuan, ChinaDepartment of Maternal and Child Health, School of Public Health, Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Peking University, Beijing, ChinaDepartment of Neonatology, Handan Central Hospital, Handan, ChinaDepartment of Pediatrics, Tianjin Medical University General Hospital, Tianjin, ChinaObjectives To determine the dose-dependent associations between antenatal corticosteroids (ANS) exposure and the rates of major morbidities, and the early weight loss percentage (EWLP) in hospital among extremely preterm infants (EPI) or extremely low birthweight infants (ELBWI).Methods A multicentre, retrospective cohort study of EPI or ELBWI born between 2017 and 2018 was conducted. Infants were classified into no ANS, partial ANS and complete ANS exposure group; three subgroups were generated by gestational age and birth weight. Multiple logistic regression and multiple linear regression were performed.Results There were 725 infants included from 32 centres. Among no ANS, partial ANS and complete ANS exposure, there were significant differences in the proportions of bronchopulmonary dysplasia (BPD) (24.5%, 25.4% and 16.1%), necrotising enterocolitis (NEC) (6.7%, 2.0% and 2.0%) and death (29.6%, 18.5% and 13.5%), and insignificant differences in the proportions of intraventricular haemorrhage (IVH) (12.5%, 13.2% and 12.2%), and extrauterine growth restriction (EUGR) (50.0%, 56.6% and 59.5%). In the logistic regression, compared with no ANS exposure, complete ANS reduced the risk of BPD (OR 0.58, 95% CI 0.37 to 0.91), NEC (OR 0.21, 95% CI 0.08 to 0.57) and death (OR 0.36, 95% CI 0.23 to 0.56), and partial ANS reduced the risk of NEC (OR 0.23, 95% CI 0.07 to 0.72) and death (OR 0.54, 95% CI 0.34 to 0.87). Compared with partial ANS exposure, complete ANS decreased the risk of BPD (OR 0.58, 95% CI 0.37 to 0.91). There were insignificant associations between ANS exposure and IVH, EUGR. In the multiple linear regression, partial and complete ANS exposure increased EWLP only in the ≥28 weeks (w) and <1000 g subgroup (p<0.05).Conclusions Different doses of ANS (dexamethasone) exposure were protectively associated with BPD, NEC, death in hospital, but not EUGR at discharge among EPI or ELBWI. Beneficial dose-dependent associations between ANS (dexamethasone) exposure and BPD existed. ANS exposure increased EWLP only in the ≥28 w and<1000 g subgroup. ANS administration, especially complete ANS, is encouraged before preterm birth.Trial registration number NCT06082414.https://bmjpaedsopen.bmj.com/content/8/1/e002506.full |
| spellingShingle | Ying Zhou Qi Feng Haijun Wang Wei Guo Xiaofang Huang Xiuying Tian Yong Ji Shuaijun Li Shufen Zhai Rongxiu Zheng Association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants: a multicentre cohort study BMJ Paediatrics Open |
| title | Association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants: a multicentre cohort study |
| title_full | Association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants: a multicentre cohort study |
| title_fullStr | Association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants: a multicentre cohort study |
| title_full_unstemmed | Association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants: a multicentre cohort study |
| title_short | Association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants: a multicentre cohort study |
| title_sort | association of different doses of antenatal corticosteroids exposure with early major outcomes and early weight loss percentage in extremely preterm infants or extremely low birthweight infants a multicentre cohort study |
| url | https://bmjpaedsopen.bmj.com/content/8/1/e002506.full |
| work_keys_str_mv | AT yingzhou associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy AT qifeng associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy AT haijunwang associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy AT weiguo associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy AT xiaofanghuang associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy AT xiuyingtian associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy AT yongji associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy AT shuaijunli associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy AT shufenzhai associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy AT rongxiuzheng associationofdifferentdosesofantenatalcorticosteroidsexposurewithearlymajoroutcomesandearlyweightlosspercentageinextremelypreterminfantsorextremelylowbirthweightinfantsamulticentrecohortstudy |