General Obstetrics and Gynecology: Fetus-Placenta-NewbornEffects of antenatal glucocorticoids on outcomes of very low birth weight multifetal gestations☆,☆☆
Section snippets
Study population and data source
With Institutional Review Board approval, a retrospective, case-control study was performed with information about Cincinnati infants in the NICHD Neonatal Research Network registry. The registry includes maternal and infant demographic and clinical data that was collected by specifically trained research nurses who used standardized definitions.13 All VLBW infants with birth weight between 401 and 1500 g who either die in the delivery room or are admitted to the NICU before 14 days of age are
Infant and maternal characteristics
Of 2357 VLBW infants who were cared for in the 3 Cincinnati NICUs from May 1991 through December 1999, 652 infants (28%) were products of multifetal gestations (497 twins, 130 triplets, 25 quadruplets). Infant and maternal characteristics are summarized in Tables I and II, respectively.Characteristic Multiple births (n = 652) Singleton births (n = 1705) All* Steroids No steroids All Steroids No steroids Mean gestational age (wk)†‡ 28 ± 3 29 ± 3 27 ± 4 28 ± 3 28 ± 3 28 ± 3 Mean birth
Comment
As in the current study, previous studies have reported that women with multifetal gestations are more likely to receive antenatal glucocorticoids.5, 8, 17 Multifetal gestations are also more likely to have been exposed to multiple courses of antenatal glucocorticoids.18 We have no information about why Cincinnati mothers of VLBW multiple infants are more likely to receive antenatal glucocorticoids. Perhaps obstetricians treat mothers of multiple infants more frequently because these infants
Acknowledgements
We thank Uma R. Kotagal, MBBS, and John L. Kiely, PhD, for their contribution to the initial study concept, and Marcia Mersmann, RN, for her assistance with use of the NICHD Neonatal Research Network registry.
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Cited by (0)
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Supported in part by a grant from the National Institute for Child Health and Human Development Cooperative Multicenter Neonatal Research Network, #U10 HD 27853.
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Reprint requests: Edward F. Donovan, MD, Cincinnati Children's Hospital Medical Center, Child Policy Research Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039.