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  • 1
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To establish whether the timing of delivery between 37 and 42 weeks gestation influences neonatal respiratory outcome and thus provide information which can be used to aid planning of elective delivery at term.Design All cases of respiratory distress syndrome or transient tachypnoea at term requiring admission to the neonatal intensive care unit were recorded prospectively for nine years.Setting Rosie Maternity Hospital, CambridgeSubjects During this time 33,289 deliveries occurred at or after 37 weeks of gestation.Main outcome measures This information enabled calculation of the relative risk of respiratory morbidity for respiratory distress syndrome or transient tachypnoea in relation to mode of delivery and onset of parturition for each week of gestation at term.Results The incidence of respiratory distress syndrome at term was 2.2/1000 deliveries (95% CI; 1.7–2.7). The incidence of transient tachypnoea was 5.7/1000 deliveries (95% CI; 4.9–6.5). The incidence of respiratory morbidity was significantly higher for the group delivered by caesarean section before the onset of labour (35.5/1000) compared with caesarean section during labour (12.2/1000) (odds ratio, 2.9; 95% CI 1.9–4.4; P 〈 0.001), and compared with vaginal delivery (5.3/1000) (odds ratio, 6.; 95% CI 5.-8.9; P 〈 0.001). The relative risk of neonatal respiratory morbidity for delivery by caesarean section before the onset of labour during the week 37+0 to 37+6 compared with the week 38+0 to 386 was 1.74 (95% CI 1.1–2.8; P 〈 0.02) and during the week 38+0 to 37+6 compared with the week 39+0 to 39+6 was 2.4 (95% CI 1.2–4.8; P 〈 0.02).Conclusions A significant reduction in neonatal respiratory morbidity would be obtained if elective caesarean section was performed in the week 39+0 to 39+6 of pregnancy.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 102 (1995), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 104 (1997), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 155 (1996), S. 576-579 
    ISSN: 1432-1076
    Keywords: Key words Antenatal steroids ; Neurodevelopmental outcome ; Follow up studies ; Betamethasone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Antenatal steroid administration reduces mortality in preterm infants. We used logistic regression analysis to explore the influence of various factors on intact survival in a population of 798 very low birth weight infants admitted between 1985 and 1992. Antenatal steroid administration (n = 87) was associated with an improved chance of normal survival with an odds ratio of 3.0 (95% confidence intervals from 1.5 to 5.9). Other factors associated with improved outcome were a normal cranial ultrasound image or one showing subependymal haemorrhage, female sex, a 5 min Apgar score above 5, low inspired oxygen concentration and higher birth weight. Year of birth was not associated with a consistent trend to improved outcome over this period and surfactant administration rates were constant throughout. These results endorse the current recommendation to increase the use of antenatal steroid therapy. Conclusion Antenatal steroid administration was associated with a threefold improvement in the chance of normal survival for very low birth weight infants as assessed at 18 months. These results suggest that the reduction in periventricular haemorrhage after antenatal steroid use is translated into a better long-term outcome.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 155 (1996), S. 576-579 
    ISSN: 1432-1076
    Keywords: Antenatal steroids ; Neurodevelopmental outcome ; Follow up studies ; Betamethasone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Antenatal steroid administration reduces mortality in preterm infants. We used logistic regression analysis to explore the influence of various factors on intact survival in a population of 798 very low birth weight infants admitted between 1985 and 1992. Antenatal steroid administration (n=87) was associated with an improved chance of normal survival with an odds ratio of 3.0 (95% confidence intervals from 1.5 to 5.9). Other factors associated with improved outcome were a normal cranial ultrasound image or one showing subependymal haemorrhage, female sec, a 5 min Apgar score above 5, low inspired oxygen concentration and higher birth weight. Year of birth was not associated with a consistent trend to improved outcome over this period and surfactant administration rates were constant throughout. These results endorse the current recommendation to increase the use of antenatal steroid therapy.
    Type of Medium: Electronic Resource
    Location Call Number Limitation Availability
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