New Trial Deepens Debate Over Late-Preterm Steroids

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Pregnancy News

Pregnant,Steroids,Otolaryngology

Steroid use is accepted to prevent neonatal respiratory distress in patients at risk before 34 weeks but remains debated for women delivering later but still preterm.

The early cancellation of a trial in southern India suggests that the use of antenatal steroids to prevent respiratory complications after late-, researchers led by Hilda Yenuberi, MD, of Christian Medical College, Vellore, Tamil Nadu, India, stopped the randomized, triple-blinded, placebo-controlled CLAP study at 70% enrollment. An interim analysis found no benefit from prescribingvs placebo to women at risk of late-preterm delivery between 34 and 36 and 6/7 weeks of gestation .

As the study notes,"the American College of Obstetricians and Gynecologists recommends a single course of betamethasone for pregnant individuals at risk of delivering between 34 and 36 6/7 weeks of gestation on the basis of the The average age of participants was 26.8 years. All were between 34 and 36 6/7 weeks of gestation and expected to give birth within the next week. A quarter of participants delivered at term, which the authors wrote"may have influenced the primary outcome." The total number of neonates was 883, including 58 twin pregnancies.

Perinatologist Cynthia Gyamfi-Bannerman, MD, MS, chair and professor of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Diego, and principal investigator of the ALPS study, said in an interview that the inclusion of twins in the new trial is"a fundamental flaw.", it is not surprising that including twins likely moved the findings to the null in this study," she said."Twins were purposefully excluded from the ALPS trial for this reason.

Neonatologist Elizabeth Asztalos, MD, MSc, an associate scientist with Sunnybrook Health Sciences Centre in Toronto, Canada, said in an interview that she doesn't worry about pregnant mothers not getting steroids later than 34 weeks."We have tools in our armamentarium in the NICU setting to help babies if they need it," said Dr. Asztalos, who didn't take part in the new trial."We can put them on CPAP if they have wet lung.

Source: Law Daily Report (lawdailyreport.net)

Pregnant Steroids Otolaryngology ENT Specialty Head And Neck Surgery ENT Speciality Sleep Apnea Sleep Apnoea Sleep Disturbance Abnormal Sleep Pattern Sleep Disorder Somnipathy Corticosteroid Acute Respiratory Distress Syndrome Acute Respiratory Distress Syndrome (Ards) Adult Respiratory Distress Syndrome Ards (Acute Respiratory Distress Syndrome)

 

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