کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6145923 1594927 2013 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Gestational age-specific risks vs benefits of multicourse antenatal corticosteroids for preterm labor
ترجمه فارسی عنوان
ریسک های خاص بارداری نسبت به مزایای کورتیکواستروئیدهای پس از زایمان چند ساله برای زایمان زودرس
کلمات کلیدی
کورتیکواستروئید روزانه تجزیه و تحلیل تصمیم گیری، زایمان زودرس
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
چکیده انگلیسی

ObjectiveThe purpose of this study was to estimate a gestational age threshold at which the benefits of treatment with weekly courses of antenatal corticosteroids (ACS) during preterm labor outweigh the risks.Study DesignRisk-benefit ratios by gestational age were determined with the use of a Markov microsimulation decision-analysis model with a 1-week cycle length. Single course and multiple (weekly to a maximum of 4) courses of ACS by gestational age of entry (23 weeks to 31 weeks 6 days' gestation) were compared. Benefits were composite events (respiratory distress syndrome, chronic lung disease, severe intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, or stillbirth) averted. Risks were small head circumference and small for gestational age.ResultsMore composite events are averted (benefits) than risks acquired (ratio, 6:1) when multiple courses of ACS are initiated at 26 weeks' gestation. When multiple courses of ACS are initiated at 29 weeks' gestation, the risk-benefit ratio is 1. Beyond 29 weeks, there is a suggestion of more risk than benefit.ConclusionThe model suggests that multiple courses of ACS that are initiated at <29 weeks' gestation may have increased benefit compared with risks. Further analyses are needed to determine the long-term clinical significance of these findings.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: American Journal of Obstetrics and Gynecology - Volume 209, Issue 4, October 2013, Pages 330.e1-330.e7
نویسندگان
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