Evidence map›Paper›PMID 30738658›Full record

Observational studyThe Journal of pediatrics2019

Discordance in Antenatal Corticosteroid Use and Resuscitation Following Extremely Preterm Birth.

Matthew A Rysavy, Edward F Bell, Jay D Iams, Waldemar A Carlo, Lei Li, Brian M Mercer, Susan R Hintz, Barbara J Stoll, Betty R Vohr, Seetha Shankaran and 6 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Journal of pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00009633 (Follow-up Visit of High Risk Infants), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00009633 recruitingnot on this map

Follow-up Visit of High Risk Infants

TypeobservationalSponsorNICHD Neonatal Research NetworkRan1993 to 2030Enrolled68,000ConditionsInfant, Newborn, Infant, Low Birth Weight, Infant, Small for Gestational Age, Infant, PrematureArmsNo Intervention
3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Matthew A RysavyDepartment of Pediatrics, University of Iowa, Iowa City, IA. Electronic address: matthew-rysavy@uiowa.edu.
Edward F BellDepartment of Pediatrics, University of Iowa, Iowa City, IA.
Jay D IamsDepartment of Obstetrics and Gynecology, Ohio State University, Columbus, OH.
Waldemar A CarloDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.
Lei LiSocial, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, NC.
Brian M MercerDepartment of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH.
Susan R HintzDepartment of Pediatrics, Stanford University School of Medicine, Palo Alto, CA.
Barbara J StollDean's Office, University of Texas Medical School at Houston, Houston, TX.
Betty R VohrDepartment of Pediatrics, Women & Infants' Hospital, Brown University, Providence, RI.
Seetha ShankaranDepartment of Pediatrics, Wayne State University, Detroit, MI.
Michele C WalshDepartment of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH.
Jane E BrumbaughDepartment of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
Tarah T ColaizyDepartment of Pediatrics, University of Iowa, Iowa City, IA.
Abhik DasSocial, Statistical, and Environmental Sciences Unit, RTI International, Rockville, MD.
Rosemary D HigginsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

Funding

Neonatal Research Network Data Coordinating Center (DCC) 2023-2028U24HD095254 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI Abhik Das · 2018 to 2026
$70.2M
Clinical and Translational Science Collaborative of ClevelandUL1TR002548 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI MCCOMSEY, GRACE A · 2018 to 2022
$35.5M
Data Ctr for the Cooperative Neonatal Research NetworkU01HD036790 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI DAS, ABHIK · 1998 to 2007
$21.8M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD021385 · NICHD · WAYNE STATE UNIVERSITY · PI SHANKARAN, SEETHA · 1991 to 2015
$8.7M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD027904 · NICHD · WOMEN AND INFANTS HOSPITAL-RHODE ISLAND · PI LAPTOOK, ABBOT R · 1991 to 2015
$8.7M
NICHD Maternal Fetal Medicine Units NetworkU10HD027915 · NICHD · OHIO STATE UNIVERSITY · PI IAMS, JAY · 1992 to 2015
$7.7M
NICHD Maternal Fetal Medicine Units NetworkU10HD040544 · NICHD · CASE WESTERN RESERVE UNIVERSITY · PI CHIEN, EDWARD K · 2001 to 2015
$7.2M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD034216 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CARLO FONT, WALDEMAR A. · 1996 to 2015
$6.4M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD027880 · NICHD · STANFORD UNIVERSITY · PI VAN MEURS, KRISA PAGE · 1991 to 2015
$6.1M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD021364 · NICHD · CASE WESTERN RESERVE UNIVERSITY · PI WALSH, MICHELE · 1991 to 2015
$6.1M
NICHD Cooperative Multicenter Neonatal Research NetworkU10HD027851 · NICHD · EMORY UNIVERSITY · PI CARLTON, DAVID · 1991 to 2015
$5.0M
NICHD Neonatal Research Network -- Cincinnati Clinical CenterUG1HD027853 · NICHD · CINCINNATI CHILDRENS HOSP MED CTR · PI STEPHANIE L MERHAR · 2016 to 2026
$3.7M
NCATS NIH HHS UL1 TR002548NICHD NIH HHS F32 HD098782NICHD NIH HHS L40 HD099827NICHD NIH HHS U01 HD036790NICHD NIH HHS U10 HD021364NICHD NIH HHS U10 HD021385NICHD NIH HHS U10 HD027851NICHD NIH HHS U10 HD027880NICHD NIH HHS U10 HD027904NICHD NIH HHS U10 HD027915NICHD NIH HHS U10 HD034216NICHD NIH HHS U10 HD040544NICHD NIH HHS U10 HD053109NICHD NIH HHS U24 HD095254NICHD NIH HHS UG1 HD021364NICHD NIH HHS UG1 HD021385NICHD NIH HHS UG1 HD027851NICHD NIH HHS UG1 HD027853NICHD NIH HHS UG1 HD027880NICHD NIH HHS UG1 HD027904NICHD NIH HHS UG1 HD034216NICHD NIH HHS UG1 HD053109NICHD NIH HHS UG1 HD087229NICHD NIH HHS UG1 HD112093
6 · The paper itself

Abstract

objectiveTo describe discordance in antenatal corticosteroid use and resuscitation following extremely preterm birth and its relationship with infant survival and neurodevelopment. STUDY

designA multicenter cohort study of 4858 infants 22-26 weeks of gestation born 2006-2011 at 24 US hospitals participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, with follow-up through 2013. Survival and neurodevelopmental outcomes were available at 18-22 months of corrected age for 4576 (94.2%) infants. We described antenatal interventions, resuscitation, and infant outcomes. We modeled the effect on infant outcomes of each hospital increasing antenatal corticosteroid exposure for resuscitated infants born at 22-24 weeks of gestation to rates observed at 25-26 weeks of gestation.

resultsDiscordant antenatal corticosteroid use and resuscitation, where one and not the other occurred, were more frequent for births at 22 and 23 but not 24 weeks (rate ratio [95% CI] at 22 weeks: 1.7 [1.3-2.2]; 23 weeks: 2.6 [2.2-3.2]; 24 weeks: 1.0 [0.8-1.2]) when compared with 25-26 weeks. Among infants resuscitated at 23 weeks, adjusting each hospital's rate of antenatal corticosteroid use to the average at 25-26 weeks (89.2%) was projected to increase infant survival by 7.1% (95% CI 5.4-8.8%) and survival without severe impairment by 6.4% (95% CI 4.7-8.1%). No significant change in outcomes was projected for infants resuscitated at 22 weeks, where few (n = 22) resuscitated infants received antenatal corticosteroids.

conclusionsInfants born at 23 weeks were more frequently resuscitated without antenatal corticosteroids than other extremely preterm infants. When resuscitation is intended, consistent provision of antenatal corticosteroids may increase infant survival and survival without impairment.

trial registrationClinicalTrials.govNCT00063063 (Generic Database) and NCT00009633 (Follow-Up Study).

Indexed as

Adrenal Cortex HormonesFemaleFollow-Up StudiesGestational AgeHumansInfantInfant, Extremely PrematureInfant, NewbornInfant, Premature, DiseasesMaleMultivariate AnalysisPremature BirthProspective StudiesResuscitationTreatment OutcomeAdrenal Cortex Hormones

Identifiers

PMID30738658
PMCPMC6486854

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.