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Master Thesis

Évaluation de la morbi-mortalité néonatale chez les extrêmes prématurés en fonction du délai entre la cure de corticothérapie anténatale et l’accouchement

Abstract : Objective: Evaluation of neonatal morbidity-mortality depending on the time period between antenatal corticosteroid (ACS) course and delivery. Patients et methods: Single-center retrospective study over 6 years, on Port Royal maternity, of 345 premature infants born between 23 and 27 weeks + 6 days, whose mother has received a single partial or complete course of ACS and comparing 3 groups depending on the time period between ACS course and delivery: less than 24 hours, between 24h and 7 days and more than 7 days. Results: By comparing our 3 groups, we have shown a higher proportion of umbilical cord arterial pH superior to 7, 20 (p=0,022), of 5 min Apgar score superior to 7 (p>0,001) and a decrease of hyaline membrane disease with a complete course of ACS (p=0,009). The composite outcome and bronchopulmonary dysplasia were not significantly different between a partial and a complete course of ACS, but we have shown that intraventricular hemorrhage grade 3 or 4 were significantly lower in the complete course group (p=0,015), and with a tendency to protect against death in this group (p=0,055). By comparing neonatal outcomes according to a complete course of ACS (more ou less 7 days), we did not show a difference, except for secondary infections that were less frequent when birth occurs after 7 days (p =0,050). Conclusion: We have shown better neonatal outcomes after a complete course of ACS than after a partial course of ACS. However, the neonatal morbidity-mortality was similar with a complete course and delivery more or less 7 days.
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Submitted on : Tuesday, September 5, 2017 - 5:48:36 PM
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Clara Matignon. Évaluation de la morbi-mortalité néonatale chez les extrêmes prématurés en fonction du délai entre la cure de corticothérapie anténatale et l’accouchement. Gynécologie et obstétrique. 2017. ⟨dumas-01582205⟩

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