Evidence map›Paper›PMID 38779045›Full record

ArticleWellcome open research2023

Antenatal corticosteroids reduce neonatal mortality in settings without assisted ventilatory support: a retrospective cohort study of early preterm births on the Thailand-Myanmar border.

Humayra Aisha Bashir, Daphne Lufting-Leeffrers, Aung Myat Min, Htun Htun Win, Nay Win Tun, Tha Gay Wah, Mary Ellen Gilder, Moo Kho Paw, Verena I Carrara, Aronrag Meeyai and 4 more

Abstract read
In one paragraph

Article in Wellcome open research, 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
–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.

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.

  1. Review
  2. Article
  3. Article
  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

14 authors.

Humayra Aisha Bashir *Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.ORCID https://orcid.org/0000-0002-9456-0433
Daphne Lufting-Leeffrers *Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.ORCID https://orcid.org/0000-0001-8830-1550
Aung Myat MinShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.ORCID https://orcid.org/0000-0003-4438-0888
Htun Htun WinShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.
Nay Win TunShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.
Tha Gay WahShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.
Mary Ellen GilderDepartment of Family Medicine, Chiang Mai University, Chiang Mai, Chiang Mai, Thailand.
Moo Kho PawShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.
Verena I CarraraShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.ORCID https://orcid.org/0000-0002-2758-0872
Aronrag MeeyaiCentre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, England, UK.ORCID https://orcid.org/0000-0002-2359-1574
Adeniyi Kolade AderobaCentre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, England, UK.ORCID https://orcid.org/0000-0002-4333-9093
François NostenShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.ORCID https://orcid.org/0000-0002-7951-0745
Mechthild M GrossMidwifery Research and Education Unit, Hannover Medical School, Hannover, Germany.
Rose McGreadyShoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand.ORCID https://orcid.org/0000-0003-1621-3257

Funding

Wellcome Trust
6 · The paper itself

Abstract

Background: Prematurity is the highest risk for under-five mortality globally. The aim of the study was to assess the effect of antenatal dexamethasone on neonatal mortality in early preterm in a resource-constrained setting without assisted ventilation. Methods: This retrospective (2008-2013) cohort study in clinics for refugees/migrants on the Thai-Myanmar border included infants born <34 weeks gestation at home, in, or on the way to the clinic. Dexamethasone, 24 mg (three 8 mg intramuscular doses, every 8 hours), was prescribed to women at risk of preterm birth (28 to <34 weeks). Appropriate newborn care was available: including oxygen but not assisted ventilation. Mortality and maternal fever were compared by the number of doses (complete: three, incomplete (one or two), or no dose). A sub-cohort participated in neurodevelopmental testing at one year. Results: Of 15,285 singleton births, 240 were included: 96 did not receive dexamethasone and 144 received one, two or three doses (56, 13 and 75, respectively). Of live-born infants followed to day 28, (n=168), early neonatal and neonatal mortality/1,000 livebirths (95%CI) with complete dosing was 217 (121-358) and 304 (190-449); compared to 394 (289-511) and 521 (407-633) with no dose. Compared to complete dosing, both incomplete and no dexamethasone were associated with elevated adjusted ORs 4.09 (1.39 to 12.00) and 3.13 (1.14 to 8.63), for early neonatal death. By contrast, for neonatal death, while there was clear evidence that no dosing was associated with higher mortality, adjusted OR 3.82 (1.42 to 10.27), the benefit of incomplete dosing was uncertain adjusted OR 1.75 (0.63 to 4.81). No adverse impact of dexamethasone on infant neurodevelopmental scores (12 months) or maternal fever was observed. Conclusions: Neonatal mortality reduction is possible with complete dexamethasone dosing in pregnancies at risk of preterm birth in settings without capacity to provide assisted ventilation.

Indexed as

Antenatal corticosteroids (ACS)assisted ventilationCPAPDexamethasoneEarly preterm birthLow resource settingsneonatal mortalityPreterm birth

Identifiers

PMID38779045
PMCPMC11109590

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