Timing of Indicated Delivery After Antenatal Steroids in Preterm Pregnancies with Severe Hypertension
Bibliographic record
Abstract
OBJECTIVES: To evaluate the effect of the time interval between administering antenatal steroids needed to accelerate fetal lung maturity and indicated delivery in preterm pregnancies complicated by severe hypertension, as determined by maternal and perinatal outcomes. METHODS: The Nova Scotia Atlee Perinatal Database was used to identify a population-based cohort of women with severe hypertension who delivered an infant between 1989 and 2002. Women were included if they received antenatal steroids and required delivery between 26 and 34 weeks gestation. Multivariate logistic regression analyses were conducted to evaluate the effect of time interval on maternal and perinatal mortality, maternal hemorrhagic and hypertension-associated morbidity, and perinatal respiratory, infectious, and prematurity-associated morbidity, while controlling for confounding variables. RESULTS: 172 pregnancies satisfied inclusion and exclusion criteria. Betamethasone was the most commonly used corticosteroid to accelerate fetal lung maturity (95%). Among infants delivered at 26 to 34 weeks, adjusted analyses showed a reduction in risk of depression at birth (RR, 0.54; 95% CI, 0.24 to 0.97) and need for surfactant (RR, 0.50; 95% CI, 0.25 to 0.95) when the time interval from steroid administration to delivery was >48 hours compared with <or= 48 hours. Adjusted analyses in a subgroup of women with cesarean delivery (81% of deliveries) demonstrated no differences in rates maternal or neonatal morbidity. CONCLUSIONS: The rates of most adverse maternal and neonatal outcomes in preterm pregnancies with severe hypertension delivered at 26 to 34 weeks are not affected by timing from steroid administration to delivery. These data support the decision for delivery based mainly on obstetrical indications.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".