Evidence map›Paper›PMID 37907932›Full record

ArticleBMC medicine2023

Association between antenatal corticosteroid treatment and severe adverse events in pregnant women.

Hui-Ju Tsai, Beth I Wallace, Akbar K Waljee, Xiumei Hong, Sheng-Mao Chang, Yi-Fen Tsai, Mei-Leng Cheong, Ann Chen Wu, Tsung-Chieh Yao

Open access · goldAbstract read
In one paragraph

Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
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  4. 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

9 authors at 7 institutions in 2 countries.

Hui-Ju TsaiInstitute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
Beth I WallaceCenter for Clinical Management Research, Lieutenant Colonel Charles S. Kettles VA Medical Center, Ann Arbor, MI, USA.
Akbar K WaljeeCenter for Clinical Management Research, Lieutenant Colonel Charles S. Kettles VA Medical Center, Ann Arbor, MI, USA.
Xiumei HongDepartment of Population, Family and Reproductive Health, Center On Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Sheng-Mao ChangDepartment of Statistics, National Taipei University, Taipei, Taiwan.
Yi-Fen TsaiInstitute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
Mei-Leng CheongNational Tsing-Hua University, Hsinchu, Taiwan.
Ann Chen WuHarvard Medical School, Boston, MA, USA.
Tsung-Chieh YaoDivision of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kweishan, Taoyuan, 33305, Taiwan. yao@adm.cgmh.org.tw.
Institute for Healthcare Improvement · USNational Health Research Institutes · TWCathay General Hospital · TWChang Gung Memorial Hospital · TWHarvard University · USJohns Hopkins University · USNational Taipei University · TW

Funding

Using SMART Design to Develop Dynamic Treatment Regimens for Glucocorticoid TaperingIK2CX002430 · VA · VETERANS HEALTH ADMINISTRATION · PI Beth Ilene Wallace · 2022 to 2026
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CSRD VA IK2 CX002430
6 · The paper itself

Abstract

backgroundAntenatal corticosteroids are considered the standard of care for pregnant women at risk for preterm birth, but studies examining their potential risks are scarce. We aimed to estimate the associations of antenatal corticosteroids with three severe adverse events: sepsis, heart failure, and gastrointestinal bleeding, in pregnant women.

methodsOf 2,157,321 pregnant women, 52,119 at 24 weeks 0/7 days to 36 weeks 6/7 days of gestation were included in this self-controlled case series study during the study period of 2009-2018. We estimated incidence rates of three severe adverse events: sepsis, heart failure, and gastrointestinal bleeding. Conditional Poisson regression was used to calculate incidence rate ratios (IRRs) for comparing incidence rates of the adverse events in each post-treatment period compared to those during the baseline period among pregnant women exposed to a single course of antenatal corticosteroid treatment.

resultsAmong 52,119 eligible participants who received antenatal corticosteroid treatment, the estimated incidence rates per 1000 person-years were 0.76 (95% confidence interval (CI): 0.69-0.83) for sepsis, 0.31 (95% CI: 0.27-0.36) for heart failure, and 11.57 (95% CI: 11.27-11.87) for gastrointestinal bleeding. The IRRs at 5 ~ 60 days after administration of antenatal corticosteroids were 5.91 (95% CI: 3.10-11.30) for sepsis and 4.45 (95% CI: 2.63-7.55) for heart failure, and 1.26 (95% CI: 1.02-1.55) for gastrointestinal bleeding; and the IRRs for days 61 ~ 180 were 2.00 (95% CI: 1.01-3.96) for sepsis, 3.65 (95% CI: 2.14-6.22) for heart failure, and 1.81 (95% CI: 1.56-2.10) for gastrointestinal bleeding.

conclusionsThis nationwide population-based study suggests that a single course of antenatal corticosteroids is significantly associated with a 1.3- to 5.9-fold increased risk of sepsis, heart failure, and gastrointestinal bleeding in pregnant women. Maternal health considerations, including recommendations for adverse event monitoring, should be included in future guidelines for antenatal corticosteroid treatment.

Indexed as

Heart FailurePremature BirthSepsisAdrenal Cortex HormonesFemaleGastrointestinal HemorrhageHumansInfant, NewbornPregnancyPregnant PeopleAdrenal Cortex HormonesAntenatalCorticosteroidsGastrointestinal bleedingHeart failureSepsis

Identifiers

PMID37907932
PMCPMC10617183
OpenAlexW4388070240

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.