Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium.
Neonatal Intensive Care Unit, Ghent University Hospital, Ghent, Belgium.
Acta Clin Belg. 2021 Dec;76(6):433-440. doi: 10.1080/17843286.2020.1758471. Epub 2020 Apr 30.
: The purpose of this study was to compare short-term outcomes in children born between 24 and 34 weeks' gestation, according to observed antenatal corticosteroids (ACS)-to-birth intervals. Research question: 'Is there a difference in short-term outcomes between observed ACS-to-birth intervals across a range of gestational ages at birth?': Cohort study assessing differences in incidence of short-term neonatal outcomes according to the observed interval between the last administration of ACS and birth. Linear, non-weighted GEE models with an independence working correlation structure were fitted to infant level data providing valid point estimates for either incidence or rate differences (binary outcomes) or average differences (continuous outcomes).: Of 886 children, 35.9% were born within 2 days after the last administration of ACS, 32.2% within 2 to 7 days, 14.1% within 8 to 14 days, and 17.8% more than 14 days after. Across gestational ages at birth, there were no differences in birth weight between children born at an ACS-to-birth interval of 7 days or less compared to more than 7 days, nor were there differences in respiratory outcomes, cerebral outcomes, or composite outcome.: Drawing conclusions on the importance of the ACS-to-birth interval is difficult due to the post-hoc nature of the variable. In the absence of tools to better estimate if and when PTB will occur, it might not have any value in daily practice, regardless of whether there is an optimal ACS-to-birth interval or not.
本研究旨在比较根据观察到的产前皮质激素(ACS)至分娩间隔,24 至 34 周龄出生婴儿的短期结局。研究问题:“在不同的出生胎龄范围内,观察到的 ACS 至分娩间隔是否会导致短期新生儿结局存在差异?”:这是一项评估根据 ACS 最后一次给药与分娩之间观察到的间隔,短期新生儿结局发生率差异的队列研究。对于婴儿水平数据,采用线性、非加权广义估计方程(GEE)模型,并采用独立性工作相关结构进行拟合,为发生率或率差异(二项结局)或平均差异(连续结局)提供有效点估计值。:在 886 名儿童中,35.9%的儿童在 ACS 最后一次给药后 2 天内出生,32.2%在 2 至 7 天内,14.1%在 8 至 14 天内,17.8%在 14 天以上出生。在不同的出生胎龄中,ACS 至分娩间隔为 7 天或更短的儿童与间隔超过 7 天的儿童相比,出生体重没有差异,呼吸结局、脑结局或复合结局也没有差异。:由于变量的事后性质,很难就 ACS 至分娩间隔的重要性得出结论。在没有工具来更好地估计 PTB 是否以及何时发生的情况下,无论是否存在最佳 ACS 至分娩间隔,它在日常实践中可能都没有价值。