Advertisement
JOGC

Mise à jour technique no 439 : Corticothérapie prénatale en période de prématurité tardive

Published:December 23, 2022DOI:https://doi.org/10.1016/j.jogc.2022.12.007

      RÉSUMÉ

      Objectif

      Mettre à jour les recommandations sur la corticothérapie prénatale dans la période de prématurité tardive.

      Population cible

      Personnes enceintes à risque d’accouchement prématuré entre 34 SA + 0 j et 36 SA + 6 j.

      Options

      Administrer ou non un traitement unique de corticothérapie prénatale entre 34 SA + 0 j et 36 SA + 6 j.

      Résultats

      Morbidité néonatale (détresse respiratoire, hypoglycémie), troubles neurodéveloppementaux à long terme et autres issues indésirables à long terme (retard de croissance, trouble cardiométabolique, problèmes respiratoires).

      Bénéfices, risques et coûts

      La corticothérapie prénatale administrée entre 34 SA + 0 j et 36 SA + 6 j diminue le risque de morbidité respiratoire néonatale, mais augmente le risque d’hypoglycémie néonatale. Les effets à long terme de la corticothérapie prénatale administrée entre 34 SA + 0 j et 36 SA + 6 j demeurent incertains.

      Données probantes

      Pour obtenir des données probantes sur les effets néonataux de l’administration d’une corticothérapie prénatale en période de prématurité tardive, les auteurs ont résumé les données de l’analyse Cochrane de 2020 sur la corticothérapie prénatale et ont combiné ces données à celles des essais randomisés répertoriés par une recherche dans la base de données Ovid MEDLINE pour les articles publiés entre le 1er janvier 2020 et le 11 mai 2022. Compte tenu du manque de données probantes directes concernant les effets de la corticothérapie prénatale en période de prématurité tardive sur le devenir neurodéveloppemental, les auteurs ont résumé les données concernant les effets de la corticothérapie prénatale sur le devenir neurodéveloppemental dans tous les âges gestationnels en utilisant les sources suivantes : (1) l’analyse Cochrane de 2020 et (2) les données probantes obtenues à partir de recherches dans les bases de données Ovid MEDLINE, Embase et Cochrane Central Register of Controlled Trials (CENTRAL) de leur création au 15 janvier 2022. Aucune restriction n’a été appliquée en ce qui concerne la date ou la langue de publication. Compte tenu du manque de données probantes directes concernant les effets de la corticothérapie prénatale en cas de prématuré sur les issues à long terme, les auteurs ont résumé les données concernant les effets de la corticothérapie prénatale sur les autres issues à long terme dans tous les âges gestationnels en combinant les données de l’analyse Cochrane de 2020 et celles tirées des études observationnelles abordant les effets à long terme de la corticothérapie prénatale sur la croissance, le devenir cardiométabolique et le devenir respiratoire, études répertoriées dans Ovid MEDLINE et publiées de sa création au 22 octobre 2021. Les auteurs ont examiné la bibliographie des études et revues systématiques retenues afin d’obtenir des références supplémentaires. Voir l’annexe A pour connaître les termes de recherche et consulter les résumés.

      Méthodes de validation

      Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique GRADE (Grading of Recommendations Assessment, Development and Evaluation). Voir l’annexe B en ligne (tableau B1 pour les définitions et tableau B2 pour l’interprétation des recommandations fortes et conditionnelles [faibles]).

      Professionnels concernés

      Fournisseurs de soins de maternité, notamment les sages-femmes, les médecins de famille et les obstétriciens.

      ABRÉVIATIONS:

      ALPS (Antenatal Late Preterm Steroids (corticothérapie prénatale en période de prématurité tardive)), CTP (corticothérapie prénatale), ECMO (oxygénation par membrane extracorporelle), ECR (essai clinique randomisé), HIV (hémorragie intraventriculaire), IC (intervalle de confiance), OMS (Organisation mondiale de la Santé), RC (rapport de cotes), RCa (rapport de cotes ajusté), RR (risque relatif), SDR (syndrome de détresse respiratoire)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Obstetrics and Gynaecology Canada
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • American College of Obstetricians Gynecologists' Committee on Obstetric Practice, Society for Maternal- Fetal Medicine
        Committee opinion no.677: antenatal corticosteroid therapy for fetal maturation.
        Obstet Gynecol. 2016; 128: e187-e194
        • Reddy U.M.
        • Deshmukh U.
        • Dude A.
        • Harper L.
        • Osmundson S.S.
        Society for Maternal-Fetal Medicine Consult Series #58: use of antenatal corticosteroids for individuals at risk for late preterm delivery: replaces SMFM Statement #4, implementation of the use of antenatal corticosteroids in the late preterm birth period in women at risk for preterm delivery, August 2016.
        Am J Obstet Gynecol. 2021; 225: B36-42
        • Stock S.J.
        • Thomson A.J.
        • Papworth S.
        • Royal College of O, Gynaecologists
        Antenatal corticosteroids to reduce neonatal morbidity and mortality: Green-top Guideline No. 74.
        BJOG. 2022; 129: e35-60
        • Kaempf J.W.
        • Suresh G.
        Antenatal corticosteroids for the late preterm infant and agnotology.
        J Perinatol. 2017; 37: 1265-1267
        • Kamath-Rayne B.D.
        • Rozance P.J.
        • Goldenberg R.L.
        • Jobe A.H.
        Antenatal corticosteroids beyond 34 weeks gestation: what do we do now?.
        Am J Obstet Gynecol. 2016; 245: 420-430
        • Skoll A.
        • Boutin A.
        • Bujold E.
        • et al.
        No. 364-antenatal corticosteroid therapy for improving neonatal outcomes.
        J Obstet Gynaecol Can. 2018; 40: 1219-1239https://doi.org/10.1016/j.jogc.2018.04.018
        • Roberts D.
        • Brown J.
        • Medley N.
        • Dalziel S.R.
        Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth.
        Cochrane Database Syst Rev. 2017; 3: CD004454
        • McGoldrick E.
        • Stewart F.
        • Parker R.
        • Dalziel S.R.
        Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth.
        Cochrane Database Syst Rev. 2020; 12: CD004454
        • Oladapo O.T.
        • Vogel J.P.
        • Piaggio G.
        • et al.
        Antenatal dexamethasone for early preterm birth in low-resource countries.
        N Engl J Med. 2020; 383: 2514-2525
        • Gyamfi-Bannerman C.
        • Thom E.A.
        • Blackwell S.C.
        • et al.
        Antenatal betamethasone for women at risk for late preterm delivery.
        N Engl J Med. 2016; 374: 1311-1320
        • Saccone G.
        • Berghella V.
        Antenatal corticosteroids for maturity of term or near term fetuses: systematic review and meta-analysis of randomized controlled trials.
        BMJ. 2016; 355: i5044
        • Liggins G.C.
        • Howie R.N.
        A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants.
        Pediatrics. 1972; 50: 515-525
        • Mansouri M.
        • Seyedolshohadaei F.
        • Company F.
        • Setare S.
        • Mazhari S.
        Effect of antenatal betamethasone on prevention of respiratory distress syndrome among neonates with gestational age of 35-36 weeks.
        J Gorga Uni Med Sci. 2010; 12: 18-23
        • Balci O.
        • Ozdemir S.
        • Mahmoud A.S.
        • Acar A.
        • Colakoglu M.C.
        The effect of antenatal steroids on fetal lung maturation between the 34th and 36th week of pregnancy.
        Gynecol Obstet Invest. 2010; 70: 95-99
        • Porto A.M.
        • Coutinho I.C.
        • Correia J.B.
        • Amorim M.M.
        Effectiveness of antenatal corticosteroids in reducing respiratory disorders in late preterm infants: randomised clinical trial.
        BMJ. 2011; 342: d1696
        • Attawattanakul N.
        • Tansupswatdikul P.
        Effects of antenatal dexamethasone on respiratory distress in late preterm infant: a randomized controlled trial.
        Thai J Obstet Gynaecol. 2015; 23: 25-33
        • Ontela V.
        • Dorairajan G.
        • Bhat V.B.
        • Chinnakali P.
        Effect of antenatal steroids on respiratory morbidity of late preterm newborns: a randomized controlled trial.
        J Trop Pediatr. 2018; 64: 531-538
        • WHO ACTION Trials Collaborators
        Antenatal dexamethasone for late preterm birth: a multi-centre, two-arm, parallel, double-blind, placebo-controlled, randomized trial.
        EClinicalMedicine. 2022; 44101285
        • Fagerlin A.
        • Zikmund-Fisher B.J.
        • Ubel P.A.
        Helping patients decide: ten steps to better risk communication.
        J Nat Cancer Inst. 2011; 103: 1436-1443
      1. Hutcheon JA, Liauw J. Improving the external validity of Antenatal Late Preterm Steroids trial findings [e-pub ahead of print]. Paediatr Perinat Epidemiol doi: 10.1111/ppe.12856. Accessed on December 12, 2022.

      2. International Patient Decision Aid Standards Collaboration. International Patient Decision Aid Standards (IPDAS) Collaboration. Available at: http://ipdas.ohri.ca/resources.html. Accessed on December 12, 2022.

        • Narvey M.R.
        • Marks S.D.
        The screening and management of newborns at risk for low blood glucose.
        Paediatr Child Health. 2019; 24: 536-554
        • Harris D.L.
        • Alsweiler J.M.
        • Ansell J.M.
        • et al.
        Outcome at 2 years after dextrose gel treatment for neonatal hypoglycemia: follow-up of a randomized trial.
        J Pediatr. 2016; 170 (e51–2): 54-59
        • McKinlay C.J.D.
        • Alsweiler J.M.
        • Anstice N.S.
        • et al.
        Association of neonatal glycemia with neurodevelopmental outcomes at 4.5 years.
        JAMA Pediatr. 2017; 171: 972-983
        • Shah R.
        • Dai D.W.T.
        • Alsweiler J.M.
        • et al.
        Association of neonatal hypoglycemia with academic performance in mid-childhood.
        JAMA. 2022; 327: 1158-1170
        • Kaiser J.R.
        • Bai S.
        • Gibson N.
        • et al.
        Association between transient newborn hypoglycemia and fourth-grade achievement test proficiency: a population-based study.
        JAMA Pediatr. 2015; 169: 913-921
        • van der Merwe J.L.
        • Sacco A.
        • Toelen J.
        • Deprest J.
        Long-term neuropathological and/or neurobehavioral effects of antenatal corticosteroid therapy in animal models: a systematic review.
        Pediatr Res. 2020; 87: 1157-1170
        • Asztalos E.V.
        • Murphy K.E.
        • Matthews S.G.
        A growing dilemma: antenatal corticosteroids and long-term consequences.
        Am J Perinatol. 2022; 39: 592-600
        • Ninan K.
        • Liyanage S.K.
        • Murphy K.E.
        • Asztalos E.V.
        • McDonald S.D.
        Evaluation of long-term outcomes associated with preterm exposure to antenatal corticosteroids: a systematic review and meta-analysis.
        JAMA Pediatr. 2022; 176e220483
        • Sotiriadis A.
        • Tsiami A.
        • Papatheodorou S.
        • Baschat A.A.
        • Sarafidis K.
        • Makrydimas G.
        Neurodevelopmental outcome after a single course of antenatal steroids in children born preterm: a systematic review and meta-analysis.
        Obst Gynecol. 2015; 125: 1385-1396
        • Schutte M.F.
        • Treffers P.E.
        • Koppe J.G.
        • Breur W.
        The influence of betamethasone and orciprenaline on the incidence of respiratory distress syndrome in the newborn after preterm labour.
        Br J Obstet Gynaecol. 1980; 87: 127-131
      3. Effects of antenatal dexamethasone administration in the infant: long-term follow-up.
        J Pediatr. 1984; 104: 259-267
        • Salokorpi T.
        • Sajaniemi N.
        • Hällback H.
        • Kari A.
        • Rita H.
        • von Wendt L.
        Randomized study of the effect of antenatal dexamethasone on growth and development of premature children at the corrected age of 2 years.
        Acta Paediatr. 1997; 86: 294-298
        • Amorim M.M.
        • Santos L.C.
        • Faúndes A.
        Corticosteroid therapy for prevention of respiratory distress syndrome in severe preeclampsia.
        Am J Obstet Gynecol. 1999; 180: 1283-1288
        • Eriksson L.
        • Haglund B.
        • Ewald U.
        • Odlind V.
        • Kieler H.
        Short and long-term effects of antenatal corticosteroids assessed in a cohort of 7,827 children born preterm.
        Acta Obstet Gynecol Scand. 2009; 88: 933-938
        • Eriksson L.
        • Haglund B.
        • Ewald U.
        • Odlind V.
        • Kieler H.
        Health consequences of prophylactic exposure to antenatal corticosteroids among children born late preterm or term.
        Acta Obstet Gynecol Scand. 2012; 91: 1415-1421
        • Hutcheon J.A.
        • Harper S.
        • Liauw J.
        • Skoll M.A.
        • Srour M.
        • Strumpf E.C.
        Antenatal corticosteroid administration and early school age child development: a regression discontinuity study in British Columbia, Canada.
        PLoS Med. 2020; 17e1003435
        • Hutcheon J.A.
        • Strumpf E.C.
        • Liauw J.
        • et al.
        Antenatal corticosteroid administration and attention-deficit/hyperactivity disorder in childhood: a regression discontinuity study.
        CMAJ. 2022; 194: E235-E241
        • Crane J.
        • Armson A.
        • Brunner M.
        • et al.
        Antenatal corticosteroid therapy for fetal maturation.
        J Obstet Gynaecol Can. 2003; 25: 45-52https://doi.org/10.1016/S1701-2163(16)31081-7
        • Aviram A.
        • Murphy K.
        • McDonald S.
        • et al.
        Antenatal corticosteroids and neurodevelopmental outcomes in late preterm births.
        Arch Dis Child Fetal Neonatal Ed. 2022; 107: 250-255
        • Vandenbroucke J.P.
        When are observational studies as credible as randomised trials?.
        Lancet. 2004; 363: 1728-1731
        • Melamed N.
        • Asztalos E.
        • Murphy K.
        • et al.
        Neurodevelopmental disorders among term infants exposed to antenatal corticosteroids during pregnancy: a population-based study.
        BMJ Open. 2019; 9e031197
        • Räikkönen K.
        • Gissler M.
        • Kajantie E.
        Associations between maternal antenatal corticosteroid treatment and mental and behavioral disorders in children.
        JAMA. 2020; 323: 1924-1933
        • Asztalos E.V.
        • Murphy K.E.
        • Willan A.R.
        • et al.
        Multiple courses of antenatal corticosteroids for preterm birth study: outcomes in children at 5 years of age (MACS-5).
        JAMA Pediatr. 2013; 167: 1102-1110
        • Crowther C.A.
        • Doyle L.W.
        • Haslam R.R.
        • et al.
        Outcomes at 2 years of age after repeat doses of antenatal corticosteroids.
        N Engl J Med. 2007; 357: 1179-1189
        • Crowther C.A.
        • Anderson P.J.
        • McKinlay C.J.
        • et al.
        Mid-childhood outcomes of repeat antenatal corticosteroids: a randomized controlled trial.
        Pediatrics. 2016; 138e20160947
        • Crowther C.A.
        • Middleton P.F.
        • Voysey M.
        • et al.
        Effects of repeat prenatal corticosteroids given to women at risk of preterm birth: an individual participant data meta-analysis.
        PLoS Med. 2019; 16e1002771
        • Walters A.
        • McKinlay C.
        • Middleton P.
        • Harding J.E.
        • Crowther C.A.
        Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes.
        Cochrane Database Syst Rev. 2022; 4: CD003935
        • Dalziel S.R.
        • Liang A.
        • Parag V.
        • Rodgers A.
        • Harding J.E.
        Blood pressure at 6 years of age after prenatal exposure to betamethasone: follow-up results of a randomized, controlled trial.
        Pediatrics. 2004; 114: 373-377
        • Smolders-de Haas H.
        • Neuvel J.
        • Schmand B.
        • TreffersPe
        • Koppe J.G.
        • Hoeks J.
        Physical development and medical history of children who were treated antenatally with corticosteroids to prevent respiratory distress syndrome: a 10- to 12- year follow up.
        Pediatrics. 1990; 86: 65-70
        • Dessens A.B.
        • Haas H.S.
        • Koppe J.G.
        Twenty year follow up of antenatal corticosteroid treatment.
        Pediatrics. 2000; 105: E77
        • Dalziel S.R.
        • Walker N.K.
        • Parag V.
        • et al.
        Cardiovascular risk factors after antenatal exposure to betamethasone: 30-year follow-up of a randomised controlled trial.
        Lancet. 2005; 365: 1856-1862
        • Doyle L.W.
        • Kitchen W.H.
        • Ford G.W.
        • Rickards A.L.
        • Kelly E.A.
        Antenatal steroid therapy and 5-year outcome of extremely low birth weight infants.
        Obstet Gynecol. 1989; 73: 743-746
        • Doyle L.W.
        • Ford G.W.
        • Rickards A.L.
        • et al.
        Antenatal corticosteroids and outcome at 14 years of age in children with birth weight less than 1501 grams.
        Pediatrics. 2000; 106: E2
        • Liu J.
        • Feng Z.C.
        • Li J.
        • Wang Q.
        Antenatal dexamethasone has no adverse effects on child physical and cognitive development: a long-term cohort follow-up investigation.
        J Matern Fetal Neonatal Med. 2012; 25: 2369-2371
        • Nixon P.A.
        • Washburn L.K.
        • O'Shea T.M.
        • et al.
        Antenatal steroid exposure and heart rate variability in adolescents born with very low birth weight.
        Pediatr Res. 2017; 81: 57-62
        • South A.M.
        • Nixon P.A.
        • Chappell M.C.
        • et al.
        Antenatal corticosteroids and the renin-angiotensin-aldosterone system in adolescents born preterm.
        Pediatr Res. 2017; 81: 88-93
        • Washburn L.K.
        • Nixon P.A.
        • Snively B.M.
        • et al.
        Antenatal corticosteroids and cardiometabolic outcomes in adolescents born with very low birth weight.
        Pediatric Res. 2017; 82: 697-703
        • Chawla S.
        • Bapat R.
        • Pappas A.
        • Bara R.
        • Zidan M.
        • Natarajan G.
        Neurodevelopmental outcome of extremely premature infants exposed to incomplete, no or complete antenatal steroids.
        J Matern Fetal Neonatal Med. 2013; 26: 1542-1547
        • Chawla S.
        • Natarajan G.
        • Shankaran S.
        • et al.
        Association of neurodevelopmental outcomes and neonatal morbidities of extremely premature infants with differential exposure to antenatal steroids.
        JAMA Pediatr. 2016; 170: 1164-1172
        • MJJ Finken
        • Keijzer-Veen M.G.
        • Dekker F.W.
        • et al.
        Antenatal glucocorticoid treatment is not associated with long-term metabolic risks in individuals born before 32 weeks of gestation.
        Arch Dis Child Fetal Neonatal Ed. 2008; 93: F442-F447
        • Kelly B.A.
        • Lewandowski A.J.
        • Worton S.A.
        • et al.
        Antenatal glucocorticoid exposure and long-term alterations in aortic function and glucose metabolism.
        Pediatrics. 2012; 129: e1282-e1290
        • Dalziel S.R.
        • Rea H.H.
        • Walker N.K.
        • et al.
        Long term effects of antenatal betamethasone on lung function: 30 Year follow up of a randomised controlled trial.
        Thorax. 2006; 61: 678-683
        • Hung Y.L.
        • Hsieh W.S.
        • Chou H.C.
        • Yang Y.H.
        • Chen C.Y.
        • Tsao P.N.
        Antenatal steroid treatment reduces childhood asthma risk in very low birth weight infants without bronchopulmonary dysplasia.
        J Perinat Med. 2010; 38: 95-102
        • Nixon P.A.
        • Washburn L.K.
        • O'Shea T.M.
        Antenatal steroid exposure and pulmonary outcomes in adolescents born with very low birth weight.
        J Perinatol. 2013; 33: 806-810
        • Nixon P.A.
        • Shaltout H.A.
        • South A.M.
        • et al.
        Antenatal steroid exposure, aerobic fitness, and physical activity in adolescents born preterm with very low birth weight.
        J Pediatr. 2019; 215: 98-106.e2
        • Pole J.D.
        • Mustard C.A.
        • To T.
        • Beyene J.
        • Allen A.C.
        Antenatal steroid therapy for fetal lung maturation: Is there an association with childhood asthma?.
        J Asthma. 2009; 46: 47-52
        • Tseng W.N.
        • Chen C.C.
        • Yu H.R.
        • Huang L.T.
        • Kuo H.C.
        Antenatal dexamethasone exposure in preterm infants is associated with allergic diseases and the mental development index in children.
        Int J Environ Res Public Health. 2016; 13: 1206
        • Gover A.
        • Brummelte S.
        • Synnes A.R.
        • et al.
        Single course of antenatal steroids did not alter cortisol in preterm infants up to 18 months.
        Acta Paediatr. 2012; 101: 604-608
        • Alexander N.
        • Rosenlöcher F.
        • Stalder T.
        • et al.
        Impact of antenatal synthetic glucocorticoid exposure on endocrine stress reactivity in term-born children.
        J Clin Endocrinol Metab. 2012; 97: 3538-3544
        • Ilg L.
        • Kirschbaum C.
        • Li S.C.
        • Rosenlöcher F.
        • Miller R.
        • Alexander N.
        Persistent effects of antenatal synthetic glucocorticoids on endocrine stress reactivity from childhood to adolescence.
        J Clin Endocrinol Metab. 2018; 104: 827-834
        • Ilg L.
        • Kirschbaum C.
        • Li S.C.
        • et al.
        No association of antenatal synthetic glucocorticoid exposure and hair steroid levels in children and adolescents.
        J Clin Endocrinol Metab. 2020; 105: 575-582
        • Edelmann M.N.
        • Sandman C.A.
        • Glynn L.M.
        • Wing D.A.
        • Davis E.P.
        Antenatal glucocorticoid treatment is associated with diurnal cortisol regulation in term-born children.
        Psychoneuroendocrinology. 2016; 72: 106-112
        • Erni K.
        • Shaqiri-Emini L.
        • La Marca R.
        • Zimmermann R.
        • Ehlert U.
        Psychobiological effects of prenatal glucocorticoid exposure in 10-year-old-children.
        Front Psychiatry. 2012; 3: 104
        • Jobe A.H.
        • Kemp M.
        • Schmidt A.
        • Takahashi T.
        • Newnham J.
        • Milad M.
        Antenatal corticosteroids: a reappraisal of the drug formulation and dose.
        Pediatr Res. 2021; 89: 318-325
        • Ninan K.
        • Morfaw F.
        • Murphy K.E.
        • Beyene J.
        • McDonald S.D.
        Neonatal and maternal outcomes of lower versus standard doses of antenatal corticosteroids for women at risk of preterm delivery: a systematic review of randomized controlled trials.
        J Obstet Gynaecol Can. 2021; 43: 74-81https://doi.org/10.1016/j.jogc.2020.02.127
        • Senat M.
        • Minoui S.
        • Multon O.
        • Fernandez H.
        • Frydman R.
        • Ville Y.
        Effect of dexamethasone and betamethasone on fetal heart rate variability in preterm labour: a randomised study.
        BJOG. 1998; 105: 749-755
        • Schmitz T.
        • Doret-Dion M.
        • Sentilhes L.
        • et al.
        Neonatal outcomes for women at risk of preterm delivery given half dose versus full dose of antenatal betamethasone: a randomised, multicentre, double-blind, placebo-controlled, non-inferiority trial.
        Lancet. 2022; 400: 592-604
      4. McDonald SD, Murphy K. Single Dose of Antenatal Corticosteroids for Pregnancies at Risk of Preterm Delivery (SNACS). Available at: https://clinicaltrials.gov/ct2/show/NCT05114096?term=SNACS&draw=2&rank=2. Accessed on Janurary 19, 2022.

      Linked Article