Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial

To determine whether prenatal corticosteroid therapy would reduce the incidence of neonatal necrotizing enterocolitis (NEC), we assigned a total of 466 women admitted in premature labor either to receive placebo (group A, n = 256), if delivery was expected to occur within 24 hours of admission, or t...

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Detalles Bibliográficos
Autores principales: Halac, Eduardo, Halac, Jacobo, Bégué, Enrique F., Casañas, Jorge M., Indiveri, Daniel R., Petit, Juan F., Figueroa, María J., Olmas, José M., Rodríguez, Luis A., Obregón, Ricardo J., Martínez, María V., Grinblat, David A.
Formato: Artículo
Lenguaje:Español
Publicado: 1990
Materias:
RJ Pediatría
Acceso en línea:http://pa.bibdigital.ucc.edu.ar/3706/1/A_Halac_Halac_Begue_Casa%C3%B1as_Indiveri_Petit_Figueroa_Olmas_Rodr%C3%ADguez_Obreg%C3%B3n_Mart%C3%ADnez_Grinbalt.pdf
Aporte de:
Producción Académica Universidad Católica de Córdoba (UCCor) de Universidad Católica de Córdoba
id I38-R144-3706
record_format dspace
spelling I38-R144-37062025-04-10T20:00:31Z http://pa.bibdigital.ucc.edu.ar/3706/ Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial Halac, Eduardo Halac, Jacobo Bégué, Enrique F. Casañas, Jorge M. Indiveri, Daniel R. Petit, Juan F. Figueroa, María J. Olmas, José M. Rodríguez, Luis A. Obregón, Ricardo J. Martínez, María V. Grinblat, David A. RJ Pediatría To determine whether prenatal corticosteroid therapy would reduce the incidence of neonatal necrotizing enterocolitis (NEC), we assigned a total of 466 women admitted in premature labor either to receive placebo (group A, n = 256), if delivery was expected to occur within 24 hours of admission, or to receive betamethasone (group B, n = 210) if delivery was expected to take place more than 24 hours after admission. All women were free of severe medical complications or drug therapy; cases of intrauterine growth retardation or premature rupture of the membranes were excluded. Their newborn infants, excluding malformed, congenitally infected, and growth-retarded infants, were enrolled in the study unless they had died before the age of 10 postnatal days. Babies born to group A mothers (n = 248) were further assigned to a treatment group (group A1, n = 130) receiving dexamethasone, 2 mg/kg/day by intravenous injection during the first 7 days of life, or to a control group (group A2, n = 118) receiving 10% dextrose solution placebo. Group B infants (prenatal betamethasone, n = 205) received neither treatment nor placebo. The incidence of NEC in group A1 was 6.9% (9/130), and in group A2 it was 14.4% (17/118) (p less than 0.05). In group B the incidence was 3.4% (7/205); this was much lower than in group A2 (p less than 0.01) and lower than in group A combined (10.4%) (p less than 0.01). There was no death from NEC and no surgical intervention among group B patients. The mortality rate for group A1 (11%) was lower than for group A2 (56%) (p less than 0.02). There were fewer indications for surgical intervention for NEC in group A1 than in group A2. Histologic studies confirmed bowel ischemia in all specimens analyzed. These data support the hypothesis that the incidence of NEC is significantly reduced after prenatal steroid treatment. Although postnatal therapy with steroids does not decrease the incidence as effectively as prenatal therapy, it improves clinical outcome of NEC. 1990-07-31 info:eu-repo/semantics/article info:eu-repo/semantics/closedAccess application/pdf spa http://pa.bibdigital.ucc.edu.ar/3706/1/A_Halac_Halac_Begue_Casa%C3%B1as_Indiveri_Petit_Figueroa_Olmas_Rodr%C3%ADguez_Obreg%C3%B3n_Mart%C3%ADnez_Grinbalt.pdf Halac, Eduardo, Halac, Jacobo, Bégué, Enrique F., Casañas, Jorge M., Indiveri, Daniel R., Petit, Juan F., Figueroa, María J., Olmas, José M., Rodríguez, Luis A., Obregón, Ricardo J., Martínez, María V. and Grinblat, David A. (1990) Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial. The Journal of Pediatrics, 117 (1). pp. 132-138. ISSN 0022-3476 info:eu-repo/semantics/altIdentifier/doi/10.1016/S0022-3476(05)72461-6
institution Universidad Católica de Córdoba
institution_str I-38
repository_str R-144
collection Producción Académica Universidad Católica de Córdoba (UCCor)
language Español
orig_language_str_mv spa
topic RJ Pediatría
spellingShingle RJ Pediatría
Halac, Eduardo
Halac, Jacobo
Bégué, Enrique F.
Casañas, Jorge M.
Indiveri, Daniel R.
Petit, Juan F.
Figueroa, María J.
Olmas, José M.
Rodríguez, Luis A.
Obregón, Ricardo J.
Martínez, María V.
Grinblat, David A.
Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial
topic_facet RJ Pediatría
description To determine whether prenatal corticosteroid therapy would reduce the incidence of neonatal necrotizing enterocolitis (NEC), we assigned a total of 466 women admitted in premature labor either to receive placebo (group A, n = 256), if delivery was expected to occur within 24 hours of admission, or to receive betamethasone (group B, n = 210) if delivery was expected to take place more than 24 hours after admission. All women were free of severe medical complications or drug therapy; cases of intrauterine growth retardation or premature rupture of the membranes were excluded. Their newborn infants, excluding malformed, congenitally infected, and growth-retarded infants, were enrolled in the study unless they had died before the age of 10 postnatal days. Babies born to group A mothers (n = 248) were further assigned to a treatment group (group A1, n = 130) receiving dexamethasone, 2 mg/kg/day by intravenous injection during the first 7 days of life, or to a control group (group A2, n = 118) receiving 10% dextrose solution placebo. Group B infants (prenatal betamethasone, n = 205) received neither treatment nor placebo. The incidence of NEC in group A1 was 6.9% (9/130), and in group A2 it was 14.4% (17/118) (p less than 0.05). In group B the incidence was 3.4% (7/205); this was much lower than in group A2 (p less than 0.01) and lower than in group A combined (10.4%) (p less than 0.01). There was no death from NEC and no surgical intervention among group B patients. The mortality rate for group A1 (11%) was lower than for group A2 (56%) (p less than 0.02). There were fewer indications for surgical intervention for NEC in group A1 than in group A2. Histologic studies confirmed bowel ischemia in all specimens analyzed. These data support the hypothesis that the incidence of NEC is significantly reduced after prenatal steroid treatment. Although postnatal therapy with steroids does not decrease the incidence as effectively as prenatal therapy, it improves clinical outcome of NEC.
format Artículo
author Halac, Eduardo
Halac, Jacobo
Bégué, Enrique F.
Casañas, Jorge M.
Indiveri, Daniel R.
Petit, Juan F.
Figueroa, María J.
Olmas, José M.
Rodríguez, Luis A.
Obregón, Ricardo J.
Martínez, María V.
Grinblat, David A.
author_facet Halac, Eduardo
Halac, Jacobo
Bégué, Enrique F.
Casañas, Jorge M.
Indiveri, Daniel R.
Petit, Juan F.
Figueroa, María J.
Olmas, José M.
Rodríguez, Luis A.
Obregón, Ricardo J.
Martínez, María V.
Grinblat, David A.
author_sort Halac, Eduardo
title Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial
title_short Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial
title_full Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial
title_fullStr Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial
title_full_unstemmed Prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial
title_sort prenatal and postnatal corticosteroid therapy to prevent neonatal necrotizing enterocolitis: a controlled trial
publishDate 1990
url http://pa.bibdigital.ucc.edu.ar/3706/1/A_Halac_Halac_Begue_Casa%C3%B1as_Indiveri_Petit_Figueroa_Olmas_Rodr%C3%ADguez_Obreg%C3%B3n_Mart%C3%ADnez_Grinbalt.pdf
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