Benefit of antenatal corticosteroids by year of birth among preterm infants in Canada during 2003–2017: a population‐based cohort study. (9th October 2020)

• Record Type: Journal Article
• Authors: Melamed, N; Murphy, K; Barrett, J; Asztalos, E; McDonald, SD; Yoon, EW; Shah, PS
• Other Names: Kanungo Jaideep investigator.; Ting Joseph investigator.; Cieslak Zenon investigator.; Sherlock Rebecca investigator.; Mehrem Ayman Abou investigator.; Toye Jennifer investigator.; Fajardo Carlos investigator.; Kalapesi Zarin investigator.; Bodani Jaya investigator.; Sankaran Koravangattu investigator.; Daspal Sibasis investigator.; Seshia Mary investigator.; Louis Deepak investigator.; Alvaro Ruben investigator.; Mukerji Amit investigator.; Da Silva Orlando investigator.; Adie Mohammad investigator.; Lee Kyong‐Soon investigator.; Dunn Michael investigator.; Lemyre Brigitte investigator.; Khurshid Faiza investigator.; Pelausa Ermelinda investigator.; Barrington Keith investigator.; Lapoint Anie investigator.; Ethier Guillaume investigator.; Drolet Christine investigator.; Piedboeuf Bruno investigator.; Claveau Martine investigator.; Beltempo Marc investigator.; Bertelle Valerie investigator.; Masse Edith investigator.; Canning Roderick investigator.; Makary Hala investigator.; Ojah Cecil investigator.; Monterrosa Luis investigator.; Emberley Julie investigator.; Afifi Jehier investigator.; Kajetanowicz Andrzej investigator.; Lee Shoo K investigator.; Abenhaim Haim investigator.; Andrews James investigator.; Armson Anthony investigator.; Audibert Francois investigator.; Aziz Khalid investigator.; Ballantyne Marilyn investigator.; Berard Anick investigator.; Blais Lucie investigator.; Bocking Alan investigator.; Burrows Jason investigator.; Butt Kimberly investigator.; Carson George investigator.; Chaillet Nils investigator.; Chandra Sue investigator.; Church Paige investigator.; Coughlin Kevin investigator.; Crane Joan investigator.; Creighton Dianne investigator.; Daboval Thierry investigator.; Dahlgren Leanne investigator.; de Cabo Cecilia investigator.; Deshpandey Akhil investigator.; Dow Kimberly investigator.; el Helou Salhab investigator.; El‐Chaar Darine investigator.; El‐Naggar Walid investigator.; Foster Jonathan investigator.; Gagnon Robert investigator.; Gratton Rob investigator.; Han Victor investigator.; Harrison Adele investigator.; Hasan Shabih investigator.; Helewa Michael investigator.; Hicks Matthew investigator.; Joseph KS investigator.; Khairy May investigator.; Lacaze‐Masmonteil Thierry investigator.; Lodha Abhay investigator.; Luu Mai investigator.; Ly Linh investigator.; Majnemer Annette investigator.; Marc Isabelle investigator.; McMillan Doug investigator.; Metcalfe Amy investigator.; Moddemann Diane investigator.; Morais Michelle investigator.; Mundle William investigator.; Murphy Lynn investigator.; Nuyt Anne‐Monique investigator.; Nwaesei Chuks investigator.; O'Brien Karel investigator.; Offringa Martin investigator.; Ouellet Annie investigator.; Pasquier Jean‐Charles investigator.; Pechlivanoglou Petros investigator.; Portales‐Casamar Elodie investigator.; Premji Shahirose investigator.; Puligandla Pramod investigator.; Pullenayegum Eleanor investigator.; Reichert Amber investigator.; Robson Kate investigator.; Schneider Carol investigator.; Shah Vibhuti investigator.; Shivananda Sandesh investigator.; Singhal Nalini investigator.; Skarsgard Erik investigator.; Skoll Amanda investigator.; Smith Graeme investigator.; Synnes Anne investigator.; Thériault Katherine investigator.; Tough Suzanne investigator.; Ubhi Jagdeep investigator.; Vincer Michael investigator.; Whittle Wendy investigator.; Whyte Hilary investigator.; Wilson Doug investigator.; Wood Stephen investigator.; Ye Philip investigator.; Yee Wendy investigator.; Zwicker Jill investigator.;
• Is Part Of: BJOG. Volume 128:Number 3(2021)
• Page Start: 521
• Page End: 531
• Publication Date: 2020-10-09
• Subjects: Benefit -- change -- corticosteroids -- over time -- trend; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.16511
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract : Objective: To evaluate the changes in the associations of antenatal corticosteroids (ACS) with neonatal mortality and severe neurological injury over time (2003–17). Design: National, population‐representative, retrospective cohort study. Setting: Level III neonatal intensive care units participating in the Canadian Neonatal Network. Population: All infants born at 23 0/7 –33 6/7 weeks of gestation ( n = 43 456). Methods: We estimated the associations between exposure to ACS and neonatal outcomes by year of birth. Year of birth was considered both continuously and categorically as three consecutive epochs. Main outcome measure: Neonatal mortality and severe neurological injury. Results: The absolute rates of neonatal mortality and severe neurological injury decreased during the study period in both the ACS and No ACS groups. For infants born at 23 0/7 –30 6/7 weeks of gestation, ACS was associated with similar reductions in neonatal mortality across the three epochs (9.0% versus 18.1%, adjusted relative risk [aRR] 0.54, 95% CI 0.47–0.61 in 2003–09; 7.6% versus 19.6%, aRR 0.51, 95% CI 0.44–0.59 in 2010–13; and 7.3% versus 14.5%, aRR 0.56, 95% CI 0.46–0.68 in 2014–17) and in severe neurological injury (13.2% versus 25.8%, aRR 0.57, 95% CI 0.50–0.64 in 2003–09; 7.4% versus 17.4%, aRR 0.53, 95% CI 0.43–0.66 in 2010–14; and 7.2% versus 14.8%, aRR 0.59, 95% CI 0.48–0.74 in 2014–17). Conclusion: Despite the ongoing improvements in neonatal care of preterm infants, as reflected by the gradual decrease in the absolute rates of neonatal mortality and severe neurological injury, the association of ACS treatment with neonatal mortality and severe neurological injury among extremely preterm infants born at 23–30 weeks of gestation has remained stable throughout the study period of 15 years. Tweetable abstract: Despite the gradual decrease in the rates of neonatal mortality and severe neurological injury, antenatal corticosteroids remain an important intervention in the current era of neonatal care. Tweetable abstract: Despite the gradual decrease in the rates of neonatal mortality and severe neurological injury, antenatal corticosteroids remain an important intervention in the current era of neonatal care.