ABSTRACT
BACKGROUND: Benefits of antenatal corticosteroids have been established for preterm infants who have received the full course. In imminent preterm labours there is no time to administer the second dose 24 h later. OBJECTIVE: To determine whether the administration of two doses of betamethasone in a 12 h interval is equivalent to the effects of a full maturation. METHODS: We performed a retrospective cohort study including preterm infants ≤34 weeks gestational age at birth and ≤1500 g, admitted to an NICU IIIC level in a tertiary hospital from 2015 to 2020. The population was divided into two cohorts: complete maturation (CM) (two doses of betamethasone 24 h apart), or advanced maturation (AM) (two doses of betamethasone 12 h apart). The primary outcomes were mortality or survival with severe morbidities. The presence of respiratory distress syndrome and other morbidities of prematurity were determined. These variables were analysed in the neonates under 28 weeks gestational age cohort. Neurodevelopment at 2 years was evaluated with the validated Ages and Stages Questionnaires®, Third Edition (ASQ®-3). Multiple regression analyses were performed and adjusted for confounding factors. RESULTS: A total of 275 preterm neonates were included. Serious outcomes did not show differences between cohorts, no increased incidence of morbidity was found in AM. A lower percentage of hypotension during the first week (p = 0.04), a tendency towards lower maximum FiO2 (p = 0.14) and to a shorter mechanical ventilation time (p = 0.14) were observed for the AM cohort. Similar results were found in the subgroup of neonates under 28 weeks gestational age. There were no differences in cerebral palsy or sensory deficits at 24 months of corrected age, although the AM cohort showed a trend towards better scores on the ASQ3 scale. CONCLUSIONS: Administration of betamethasone every 12 h showed similar results to the traditional pattern with respect to mortality and severe morbidities. No deleterious neurodevelopmental effects were found at 24 months of corrected age. Earlier administration of betamethasone at 12 h after the first dose would be an alternative in imminent preterm delivery. Further studies are needed to confirm these results.
ABSTRACT
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Subject(s)
Humans , Male , Female , Infant, Newborn , Abnormalities, Multiple/genetics , Intellectual Disability/genetics , Epilepsy/complications , Epilepsy/diagnosis , Mutation/genetics , Chromosomes, Human, Pair 17 , Hybridization, Genetic/genetics , Muscle Hypotonia/complications , Body Dysmorphic Disorders/complications , Body Dysmorphic Disorders/diagnosis , Skull/pathology , Skull , Diagnosis, DifferentialABSTRACT
INTRODUCCIÓN: La tosferina es una enfermedad reemergente que afecta sobre todo a lactantes. A esta edad la gravedad se puede afectar por infecciones intercurrentes como la del virus respiratorio sincitial (VRS). OBJETIVOS: Estimar la incidencia de la infección por el VRS durante su época epidémica en pacientes ingresados por tosferina. Asimismo, estudiar su repercusión sobre la gravedad observada durante el ingreso. Pacientes y método: Estudio descriptivo de casos con diagnóstico de tosferina ingresados en un hospital terciario durante 3 años donde se analizó la presencia de coinfección por el VRS. La estimación de la gravedad se confrontó por la incidencia de complicaciones y el nivel de cuidados requeridos. RESULTADOS: De un total de 73 lactantes con tosferina, 34 acontecieron en época epidémica de bronquiolitis. En 17 de los 34 se detectó coinfección por el VRS. La edad media no mostró diferencias significativas respecto a los no coinfectados. La estancia media y la necesidad de cuidados intensivos fue semejante. La necesidad de cuidados de oxigenoterapia y soporte nutricional fue superior en los coinfectados. CONCLUSIONES: La coinfección por el VRS en lactantes ingresados con tosferina aconteció en uno de cada 2 pacientes en época epidémica para el VRS, en lactantes de edad similar. La gravedad en términos de estancia, presencia de apneas e ingreso en cuidados intensivos fue semejante, pero con mayor necesidad de cuidados respiratorios y soporte nutricional
INTRODUCTION: Pertussis is a re-emerging disease that mostly affects infants. At this age, the severity can be affected by intercurrent infections such as respiratory syncytial virus (RSV). OBJECTIVES: To estimate the incidence of RSV infection during an epidemic period in patients hospitalized due to pertussis. The impact on the severity was also observed during hospitalization. PATIENTS AND METHOD: A descriptive study of cases diagnosed with pertussis admitted to a tertiary hospital over a 3 year period, where the presence of co-infection with RSV was analyzed. The estimate of severity was estimated using the incidence of complications and the level of care required. RESULTS: From a total of 73 infants with pertussis, 34 occurred in a bronchiolitis season epidemic. A co- infection due to RSV was detected in 17 patients. The mean age was not significantly different compared to the non co-infected. The mean stay and the need for intensive care was similar in both groups. The need for oxygen therapy care and nutritional support was higher in the coinfected patients. CONCLUSIONS: Coinfection with RSV in infants hospitalized with pertussis occurred in ono in 2 patients during a RSV epidemic season, in infants of similar age. Severity in terms of stay, presence of apnea and admission to intensive care was similar, but more need for respiratory care and nutritional support was found
Subject(s)
Female , Humans , Infant , Male , Whooping Cough/diagnosis , Whooping Cough/epidemiology , Whooping Cough/microbiology , Respiratory Syncytial Virus, Human/isolation & purification , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/microbiology , Coinfection/complications , Coinfection/diagnosis , Coinfection/microbiology , Oxygen/therapeutic use , Cohort Studies , Bordetella pertussis/isolation & purificationABSTRACT
INTRODUCTION: Pertussis is a re-emerging disease that mostly affects infants. At this age, the severity can be affected by intercurrent infections such as respiratory syncytial virus (RSV). OBJECTIVES: To estimate the incidence of RSV infection during an epidemic period in patients hospitalized due to pertussis. The impact on the severity was also observed during hospitalization. PATIENTS AND METHOD: A descriptive study of cases diagnosed with pertussis admitted to a tertiary hospital over a 3year period, where the presence of co-infection with RSV was analyzed. The estimate of severity was estimated using the incidence of complications and the level of care required. RESULTS: From a total of 73 infants with pertussis, 34 occurred in a bronchiolitis season epidemic. A co-infection due to RSV was detected in 17 patients. The mean age was not significantly different compared to the non co-infected. The mean stay and the need for intensive care was similar in both groups. The need for oxygen therapy care and nutritional support was higher in the coinfected patients. CONCLUSIONS: Coinfection with RSV in infants hospitalized with pertussis occurred in ono in 2 patients during a RSV epidemic season, in infants of similar age. Severity in terms of stay, presence of apnea and admission to intensive care was similar, but more need for respiratory care and nutritional support was found.
