Rescue antenatal corticosteroids and neonatal outcomes in twin gestation
Roy Zigron1, Ira Erlichman2, Misgav Rottenstreich1
1Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Summary
A rescue course of antenatal corticosteroids (ACS) significantly improved respiratory and neonatal outcomes in twin pregnancies. This intervention reduced adverse respiratory events and shortened hospital stays for preterm twins.
Area of Science:
- Neonatal Medicine
- Maternal-Fetal Medicine
- Pharmacology
Background:
- Repeated antenatal corticosteroids (ACS) are not recommended.
- A single ACS course benefits preterm singletons.
- Effects of rescue ACS in twin pregnancies are understudied.
Purpose of the Study:
- To evaluate the impact of a rescue course of antenatal corticosteroids (ACS) on neonatal outcomes in twin pregnancies.
- To compare outcomes between twins receiving a single ACS course versus those receiving a rescue ACS course.
Main Methods:
- Retrospective cohort study (2015-2017) at a tertiary-care center.
- Included twins delivered between 24-34 weeks gestation who received at least one ACS course.
- Compared outcomes for single ACS course versus rescue ACS course groups.
Main Results:
- Rescue ACS was associated with lower rates of respiratory distress syndrome (7.4% vs. 19.1%), surfactant use (7.4% vs. 18.5%), and bronchopulmonary dysplasia (0% vs. 8.6%).
- Composite respiratory adverse outcomes (10.3% vs. 22.2%) and any adverse neonatal outcomes (13.2% vs. 26.5%) were significantly lower in the rescue ACS group.
- Neonates in the rescue ACS group had shorter hospital stays (median 23 vs. 30 days).
Conclusions:
- A rescue course of antenatal corticosteroids (ACS) is associated with improved respiratory and overall neonatal outcomes in twin gestations.
- Further research is needed to confirm these findings and optimize rescue ACS regimens for twin pregnancies.
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