Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates

Beverly A. Banks; George Macones; Avital Cnaan; Jeffrey D. Merrill; Philip L. Ballard; Roberta A. Ballard; J. Pinto-Martin; B. Planer; M. McCarthy; E. Escobar; M. Morgan; E. Anday; K. Mooney; M. Johnson; W. Parer; R. Phibbs; N. Newton; J. Milar; J. Padbury; M. Ross; D. Polk; S. Harrington; D. Davis; K. Ash; J. Frank; E. Tyrala; L. Chan; J. Lioy; R. Librizzi; M. Hart; J. Garbaciak; E. Ramthun; S. Sawai; C. Carballo; F. Mannino; T. Moore; E. Milan; H. Schneider; D. Block; J. Keith; M. Rivera-Alsina; N. Ragavan; N. Dunn; V. Bhutani; S. Weiner; M. Grous

doi:10.1038/sj/jp/7210604

Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates

Beverly A. Banks
, George Macones
, Avital Cnaan
, Jeffrey D. Merrill
, Philip L. Ballard
, Roberta A. Ballard
, J. Pinto-Martin
, B. Planer
, M. McCarthy
, E. Escobar
, M. Morgan
, E. Anday
, K. Mooney
, M. Johnson
, W. Parer
, R. Phibbs
, N. Newton
, J. Milar
, J. Padbury
, M. Ross

D. Polk, S. Harrington, D. Davis, K. Ash, J. Frank, E. Tyrala, L. Chan, J. Lioy, R. Librizzi, M. Hart, J. Garbaciak, E. Ramthun, S. Sawai, C. Carballo, F. Mannino, T. Moore, E. Milan, H. Schneider, D. Block, J. Keith, M. Rivera-Alsina, N. Ragavan, N. Dunn, V. Bhutani, S. Weiner, M. Grous

Division of Clinical Research

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

Objective: Determine whether the increased neonatal mortality following repeated courses of antenatal corticosteroids (ANCS), observed in the Thyrotropin-Releasing Hormone (TRH) Trial, was related to confounding maternal risk factors or specific preterm morbidities. Study Design: A post hoc analysis of 595 TRH trial neonates, 26 to 32 weeks' gestation, studied the association between ≥3 courses ANCS and mortality. Potential confounding maternal factors and preterm morbidities were evaluated using logistic regression and log likelihood modeling. Results: Mortality was 9.2% after ≥3 courses (13/141) vs. 4.8% after 1 or 2 courses (22/454). This association was not explained by maternal factors, or other common preterm morbidities. However, 15/141 infants receiving ≥3 courses (10.6%) had early severe lung disease (ESLD) with 10 deaths, compared to 16/454 of the 1- to 2-course infants (3.5%) with 7 deaths (odds ratio 3.5, p < 0.001). Conclusions. ESLD, but no maternal risk factors, was associated with increased mortality in preterm infants after ≥ 3 courses ANCS.

Original language	English
Pages (from-to)	101-107
Number of pages	7
Journal	Journal of Perinatology
Volume	22
Issue number	2
DOIs	https://doi.org/10.1038/sj/jp/7210604
State	Published - 2002

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Banks, B. A., Macones, G., Cnaan, A., Merrill, J. D., Ballard, P. L., Ballard, R. A., Pinto-Martin, J., Planer, B., McCarthy, M., Escobar, E., Morgan, M., Anday, E., Mooney, K., Johnson, M., Parer, W., Phibbs, R., Newton, N., Milar, J., Padbury, J., ... Grous, M. (2002). Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates. Journal of Perinatology, 22(2), 101-107. https://doi.org/10.1038/sj/jp/7210604

@article{e13ade85adc3440d9c4ff2752525a636,

title = "Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates",

abstract = "Objective: Determine whether the increased neonatal mortality following repeated courses of antenatal corticosteroids (ANCS), observed in the Thyrotropin-Releasing Hormone (TRH) Trial, was related to confounding maternal risk factors or specific preterm morbidities. Study Design: A post hoc analysis of 595 TRH trial neonates, 26 to 32 weeks' gestation, studied the association between ≥3 courses ANCS and mortality. Potential confounding maternal factors and preterm morbidities were evaluated using logistic regression and log likelihood modeling. Results: Mortality was 9.2\% after ≥3 courses (13/141) vs. 4.8\% after 1 or 2 courses (22/454). This association was not explained by maternal factors, or other common preterm morbidities. However, 15/141 infants receiving ≥3 courses (10.6\%) had early severe lung disease (ESLD) with 10 deaths, compared to 16/454 of the 1- to 2-course infants (3.5\%) with 7 deaths (odds ratio 3.5, p < 0.001). Conclusions. ESLD, but no maternal risk factors, was associated with increased mortality in preterm infants after ≥ 3 courses ANCS.",

author = "Banks, \{Beverly A.\} and George Macones and Avital Cnaan and Merrill, \{Jeffrey D.\} and Ballard, \{Philip L.\} and Ballard, \{Roberta A.\} and J. Pinto-Martin and B. Planer and M. McCarthy and E. Escobar and M. Morgan and E. Anday and K. Mooney and M. Johnson and W. Parer and R. Phibbs and N. Newton and J. Milar and J. Padbury and M. Ross and D. Polk and S. Harrington and D. Davis and K. Ash and J. Frank and E. Tyrala and L. Chan and J. Lioy and R. Librizzi and M. Hart and J. Garbaciak and E. Ramthun and S. Sawai and C. Carballo and F. Mannino and T. Moore and E. Milan and H. Schneider and D. Block and J. Keith and M. Rivera-Alsina and N. Ragavan and N. Dunn and V. Bhutani and S. Weiner and M. Grous",

note = "Funding Information: This study was supported by grants RO1-HD29201, P50-HL56401, MO1-RR00240, MO1-RR00040, MO1-RR00042, and MO1-RR01271 and by Perinatal Associates, Inc., and the Children's Hospital of Eastern Ontario Research Institution.",

year = "2002",

doi = "10.1038/sj/jp/7210604",

language = "English",

volume = "22",

pages = "101--107",

journal = "Journal of Perinatology",

issn = "0743-8346",

number = "2",

}

Banks, BA, Macones, G, Cnaan, A, Merrill, JD, Ballard, PL, Ballard, RA, Pinto-Martin, J, Planer, B, McCarthy, M, Escobar, E, Morgan, M, Anday, E, Mooney, K, Johnson, M, Parer, W, Phibbs, R, Newton, N, Milar, J, Padbury, J, Ross, M, Polk, D, Harrington, S, Davis, D, Ash, K, Frank, J, Tyrala, E, Chan, L, Lioy, J, Librizzi, R, Hart, M, Garbaciak, J, Ramthun, E, Sawai, S, Carballo, C, Mannino, F, Moore, T, Milan, E, Schneider, H, Block, D, Keith, J, Rivera-Alsina, M, Ragavan, N, Dunn, N, Bhutani, V, Weiner, S & Grous, M 2002, 'Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates', Journal of Perinatology, vol. 22, no. 2, pp. 101-107. https://doi.org/10.1038/sj/jp/7210604

TY - JOUR

T1 - Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates

AU - Banks, Beverly A.

AU - Macones, George

AU - Cnaan, Avital

AU - Merrill, Jeffrey D.

AU - Ballard, Philip L.

AU - Ballard, Roberta A.

AU - Pinto-Martin, J.

AU - Planer, B.

AU - McCarthy, M.

AU - Escobar, E.

AU - Morgan, M.

AU - Anday, E.

AU - Mooney, K.

AU - Johnson, M.

AU - Parer, W.

AU - Phibbs, R.

AU - Newton, N.

AU - Milar, J.

AU - Padbury, J.

AU - Ross, M.

AU - Polk, D.

AU - Harrington, S.

AU - Davis, D.

AU - Ash, K.

AU - Frank, J.

AU - Tyrala, E.

AU - Chan, L.

AU - Lioy, J.

AU - Librizzi, R.

AU - Hart, M.

AU - Garbaciak, J.

AU - Ramthun, E.

AU - Sawai, S.

AU - Carballo, C.

AU - Mannino, F.

AU - Moore, T.

AU - Milan, E.

AU - Schneider, H.

AU - Block, D.

AU - Keith, J.

AU - Rivera-Alsina, M.

AU - Ragavan, N.

AU - Dunn, N.

AU - Bhutani, V.

AU - Weiner, S.

AU - Grous, M.

N1 - Funding Information: This study was supported by grants RO1-HD29201, P50-HL56401, MO1-RR00240, MO1-RR00040, MO1-RR00042, and MO1-RR01271 and by Perinatal Associates, Inc., and the Children's Hospital of Eastern Ontario Research Institution.

PY - 2002

Y1 - 2002

N2 - Objective: Determine whether the increased neonatal mortality following repeated courses of antenatal corticosteroids (ANCS), observed in the Thyrotropin-Releasing Hormone (TRH) Trial, was related to confounding maternal risk factors or specific preterm morbidities. Study Design: A post hoc analysis of 595 TRH trial neonates, 26 to 32 weeks' gestation, studied the association between ≥3 courses ANCS and mortality. Potential confounding maternal factors and preterm morbidities were evaluated using logistic regression and log likelihood modeling. Results: Mortality was 9.2% after ≥3 courses (13/141) vs. 4.8% after 1 or 2 courses (22/454). This association was not explained by maternal factors, or other common preterm morbidities. However, 15/141 infants receiving ≥3 courses (10.6%) had early severe lung disease (ESLD) with 10 deaths, compared to 16/454 of the 1- to 2-course infants (3.5%) with 7 deaths (odds ratio 3.5, p < 0.001). Conclusions. ESLD, but no maternal risk factors, was associated with increased mortality in preterm infants after ≥ 3 courses ANCS.

AB - Objective: Determine whether the increased neonatal mortality following repeated courses of antenatal corticosteroids (ANCS), observed in the Thyrotropin-Releasing Hormone (TRH) Trial, was related to confounding maternal risk factors or specific preterm morbidities. Study Design: A post hoc analysis of 595 TRH trial neonates, 26 to 32 weeks' gestation, studied the association between ≥3 courses ANCS and mortality. Potential confounding maternal factors and preterm morbidities were evaluated using logistic regression and log likelihood modeling. Results: Mortality was 9.2% after ≥3 courses (13/141) vs. 4.8% after 1 or 2 courses (22/454). This association was not explained by maternal factors, or other common preterm morbidities. However, 15/141 infants receiving ≥3 courses (10.6%) had early severe lung disease (ESLD) with 10 deaths, compared to 16/454 of the 1- to 2-course infants (3.5%) with 7 deaths (odds ratio 3.5, p < 0.001). Conclusions. ESLD, but no maternal risk factors, was associated with increased mortality in preterm infants after ≥ 3 courses ANCS.

UR - https://www.scopus.com/pages/publications/0036198407

U2 - 10.1038/sj/jp/7210604

DO - 10.1038/sj/jp/7210604

M3 - Article

C2 - 11896513

AN - SCOPUS:0036198407

SN - 0743-8346

VL - 22

SP - 101

EP - 107

JO - Journal of Perinatology

JF - Journal of Perinatology

IS - 2

ER -

Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates

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