Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates
Background ?Before the advent of antenatal steroids, early non-invasive respiratory support (NIV), and intratracheal surfactant, antenatal terbutaline was also used to improve lung compliance and reduce the incidence of respiratory distress syndrome (RDS). Objectives ?The objective of this paper was...
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th-mahidol.785402022-08-04T18:04:00Z Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates Visanu Kittiarpornpon Pitiporn Siripattanapipong Walaiporn Bowornkitiwong Ratchada Kitsommart Sopapan Ngerncham Pimol Wongsiridach Buranee Yangthara Siriraj Hospital Medicine Background ?Before the advent of antenatal steroids, early non-invasive respiratory support (NIV), and intratracheal surfactant, antenatal terbutaline was also used to improve lung compliance and reduce the incidence of respiratory distress syndrome (RDS). Objectives ?The objective of this paper was to study the association between antenatal terbutaline and endotracheal intubation (ET) within the first 24 hours of life, RDS, bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH) in infants with the gestational age (GA) of <32 weeks, and to study the association between antenatal terbutaline, and ET or NIV within the first 24 hours of life, and RDS in infants with the GA of 32 to 36 weeks. Method ?This was a retrospective medical record review of preterm infants delivered at a single tertiary care center from October 2016 to December 2020. Multivariable logistic regression was used to explore the association between antenatal terbutaline and neonatal respiratory support. Result ?1,794 infants were included, 234 (13.0%) had the GA of <32 weeks and 1,560 (86.9%) had the GA of 32 to 36 weeks. Antenatal terbutaline, corticosteroid, or both agents were administered in 561 (31.3%), 1,461 (81.4%), and 555 (30.9%), respectively. Antenatal terbutaline was significantly associated with a reduction in ET (adjusted odds ratio [aOR] = 0.40, 95% confident interval [CI] 0.19-0.82, p = 0.012) in infants with the GA of <32 weeks, but not in infants with the GA of 32-36 weeks. Antenatal terbutaline was not associated with RDS or BPD but was significantly associated with a reduction in grade III-IV IVH (aOR 0.11, CI 0.01-0.98; p = 0.048), in infants with the GA of <32 weeks. Conclusion ?In a state-of-the-art neonatal care setting, antenatal terbutaline was associated with a reduction in ET during the first 24 hours in infants with the GA of <32 weeks. The use of antenatal terbutaline to improve acute neonatal respiratory outcomes merits reconsideration. Key Points The neonatal respiratory benefits of antenatal terbutaline in the era of antenatal corticosteroids were uncertain. Terbutaline is associated with a reduction in endotracheal intubation in a modern care setting. The role of terbutaline, and potentially other betamimetics, to improve neonatal respiratory outcomes merits reconsideration. 2022-08-04T11:04:00Z 2022-08-04T11:04:00Z 2021-01-01 Article American Journal of Perinatology. (2021) 10.1055/a-1695-8220 10988785 07351631 2-s2.0-85121741120 https://repository.li.mahidol.ac.th/handle/123456789/78540 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85121741120&origin=inward |
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Medicine Visanu Kittiarpornpon Pitiporn Siripattanapipong Walaiporn Bowornkitiwong Ratchada Kitsommart Sopapan Ngerncham Pimol Wongsiridach Buranee Yangthara Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates |
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Background ?Before the advent of antenatal steroids, early non-invasive respiratory support (NIV), and intratracheal surfactant, antenatal terbutaline was also used to improve lung compliance and reduce the incidence of respiratory distress syndrome (RDS). Objectives ?The objective of this paper was to study the association between antenatal terbutaline and endotracheal intubation (ET) within the first 24 hours of life, RDS, bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH) in infants with the gestational age (GA) of <32 weeks, and to study the association between antenatal terbutaline, and ET or NIV within the first 24 hours of life, and RDS in infants with the GA of 32 to 36 weeks. Method ?This was a retrospective medical record review of preterm infants delivered at a single tertiary care center from October 2016 to December 2020. Multivariable logistic regression was used to explore the association between antenatal terbutaline and neonatal respiratory support. Result ?1,794 infants were included, 234 (13.0%) had the GA of <32 weeks and 1,560 (86.9%) had the GA of 32 to 36 weeks. Antenatal terbutaline, corticosteroid, or both agents were administered in 561 (31.3%), 1,461 (81.4%), and 555 (30.9%), respectively. Antenatal terbutaline was significantly associated with a reduction in ET (adjusted odds ratio [aOR] = 0.40, 95% confident interval [CI] 0.19-0.82, p = 0.012) in infants with the GA of <32 weeks, but not in infants with the GA of 32-36 weeks. Antenatal terbutaline was not associated with RDS or BPD but was significantly associated with a reduction in grade III-IV IVH (aOR 0.11, CI 0.01-0.98; p = 0.048), in infants with the GA of <32 weeks. Conclusion ?In a state-of-the-art neonatal care setting, antenatal terbutaline was associated with a reduction in ET during the first 24 hours in infants with the GA of <32 weeks. The use of antenatal terbutaline to improve acute neonatal respiratory outcomes merits reconsideration. Key Points The neonatal respiratory benefits of antenatal terbutaline in the era of antenatal corticosteroids were uncertain. Terbutaline is associated with a reduction in endotracheal intubation in a modern care setting. The role of terbutaline, and potentially other betamimetics, to improve neonatal respiratory outcomes merits reconsideration. |
author2 |
Siriraj Hospital |
author_facet |
Siriraj Hospital Visanu Kittiarpornpon Pitiporn Siripattanapipong Walaiporn Bowornkitiwong Ratchada Kitsommart Sopapan Ngerncham Pimol Wongsiridach Buranee Yangthara |
format |
Article |
author |
Visanu Kittiarpornpon Pitiporn Siripattanapipong Walaiporn Bowornkitiwong Ratchada Kitsommart Sopapan Ngerncham Pimol Wongsiridach Buranee Yangthara |
author_sort |
Visanu Kittiarpornpon |
title |
Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates |
title_short |
Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates |
title_full |
Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates |
title_fullStr |
Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates |
title_full_unstemmed |
Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates |
title_sort |
association of antenatal terbutaline and respiratory support requirements in preterm neonates |
publishDate |
2022 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/78540 |
_version_ |
1763492377342771200 |