Academic Journal
Exposure to repeat doses of antenatal glucocorticoids is associated with altered cardiovascular status after birth
| العنوان: | Exposure to repeat doses of antenatal glucocorticoids is associated with altered cardiovascular status after birth |
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| المؤلفون: | Mildenhall, Lindsay F J, Battin, Malcolm R, Morton, Susan MB, Bevan, Coila, Kuschel, Carl A, Harding, Jane E |
| بيانات النشر: | British Medical Journal Publishing Group |
| سنة النشر: | 2005 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | Original articles |
| الوصف: | Objective: To determine if exposure to more than one course of antenatal glucocorticoids is associated with changes in infant blood pressure and myocardial wall thickness in the first month after birth. Design: Prospective cohort study Setting: Tertiary Neonatal Intensive Care Unit Participants: Mothers who were eligible for but declined to enter a randomised trial of repeated doses of antenatal glucocorticoids (ACTORDS) i.e. who had a singleton, twin or triplet pregnancy at <32 weeks gestation, had received an initial course of glucocorticoids seven or more days previously and were considered to be at continued risk of preterm birth. Main outcome measures: Blood pressure daily for the first week then weekly until 4 weeks of age. End diastolic interventricular septal and left ventricular posterior wall thickness (EDIVS and EDLVPW) at 48-72h after birth. Results: Thirty seven women were enrolled and delivered 50 infants. Thirty mothers (39 infants) were exposed to one course of glucocorticoids and 7 mothers (11 infants) to more than one course. Blood pressures were higher in the first week after birth in infants exposed to multiple courses of glucocorticoids, and in infants with a latency between last exposure and delivery of less than 7 days. Systolic blood pressure on day 1 was >2SD above published normal ranges in 67% of babies exposed to multiple courses and 24% of babies exposed to a single course of glucocorticoids (P=0.04). There was no difference between groups in thickness of the EDIVS or EDLVPW. However 44/50 (88%) babies had EDIVS and 49/50 (98%) babies had EDLVPW thickness >2 SD above the expected mean for birthweight and gestation. EDIVS but not EDLVPW thickness increased with increasing latency (mean 0.02mm per day, p = 0.03). Conclusion: Future randomised trials should assess the longterm effects of exposure to antenatal glucocorticoids, and particularly multiple courses, on the cardiovascular status of the infant. |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| Relation: | http://fn.bmj.com/cgi/content/short/adc.2004.065300v1; http://dx.doi.org/10.1136/adc.2004.065300 |
| DOI: | 10.1136/adc.2004.065300 |
| الاتاحة: | http://fn.bmj.com/cgi/content/short/adc.2004.065300v1 https://doi.org/10.1136/adc.2004.065300 |
| Rights: | Copyright (C) 2005, BMJ Publishing Group |
| رقم الانضمام: | edsbas.3E65B2C0 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/adc.2004.065300 |
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