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Antenatal corticosteroids and outcomes in gastroschisis: A multicenter retrospective cohort study

Carnaghan, H; James, C; Charlesworth, P; Ghionzoli, M; Pereira, S; Elkhouli, M; Baud, D; ... Eaton, S; + view all (2020) Antenatal corticosteroids and outcomes in gastroschisis: A multicenter retrospective cohort study. Prenatal Diagnosis , 40 (8) pp. 991-997. 10.1002/pd.5727. Green open access

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Abstract

Objective: In gastroschisis, there is evidence to suggest that gut dysfunction develops secondary to bowel inflammation; we aimed to evaluate the effect of maternal antenatal corticosteroids administered for obstetric reasons on time to full enteral feeds in a multicenter cohort study of gastroschisis infants. Methods: A three center, retrospective cohort study (1992‐2013) with linked fetal/neonatal gastroschisis data was conducted. The primary outcome measure was time to full enteral feeds (a surrogate measure for bowel function) and secondary outcome measure was length of hospital stay. Analysis included Mann‐Whitney and Cox regression. Results: Of 500 patients included in the study, 69 (GA at birth 34 [25‐38] weeks) received antenatal corticosteroids and 431 (GA at birth 37 [31‐41] weeks) did not. Antenatal corticosteroids had no effect on the rate of reaching full feeds (Hazard ratio HR 1.0 [95% CI: 0.8‐1.4]). However, complex gastroschisis (HR 0.3 [95% CI: 0.2‐0.4]) was associated with an increased time to reach full feeds and later GA at birth (HR 1.1 per week increase in GA [95% CI: 1.1‐1.2]) was associated with a decreased time to reach full feeds. Conclusion: Maternal antenatal corticosteroids use, under current antenatal steroid protocols, in gastroschisis is not associated with an improvement in neonatal outcomes such as time to full enteral feeds or length of hospital stay.

Type: Article
Title: Antenatal corticosteroids and outcomes in gastroschisis: A multicenter retrospective cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/pd.5727
Publisher version: https://doi.org/10.1002/pd.5727
Language: English
Additional information: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10096485
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