Antenatal Corticosteroids and Outcomes of Small-for-Gestational-Age Neonates
Bibliographic record
Abstract
OBJECTIVE: To assess the association of antenatal corticosteroids and neonatal outcomes of preterm small-for-gestational-age (SGA) neonates and estimate whether the association is similar to that observed in appropriate-for-gestational-age (AGA) neonates. METHODS: We conducted a retrospective cohort study using data collected on singleton neonates born between 24 0/7 and 33 6/7 weeks of gestation and admitted to tertiary neonatal units in Canada between 2010 and 2014. Outcomes of SGA neonates (birth weight less than the 10th percentile) who received antenatal corticosteroids 1-7 days before birth (n=698) were compared with those of SGA neonates who did not receive antenatal corticosteroids (n=220). A similar comparison was performed between AGA neonates (birth weight between 10th and 90th percentile) who received antenatal corticosteroids 1-7 days before birth (n=3,781) and AGA neonates that did not receive antenatal corticosteroids (n=1,868). The association of antenatal corticosteroid exposure with outcomes was assessed using multivariable logistic regression and adjusted odds ratios (ORs) were compared between SGA and AGA groups. RESULTS: Of the 6,567 neonates eligible for the study, 918 (14.0%) were SGA. Women in the SGA group who were exposed to antenatal corticosteroids had a lower rate of neonatal death (7% compared with 12%, P=.01) compared with those not exposed to antenatal corticosteroids, whereas the rate of composite outcome was similar between the two groups (28% compared with 30%, P=.56). After adjustment for potential confounders, exposure to antenatal corticosteroids 1-7 days before birth was associated with beneficial effects among both the SGA and AGA groups with similar reduced odds of neonatal death (SGA: adjusted OR 0.29 [95% confidence interval (CI) 0.15-0.57] compared with AGA: adjusted OR 0.40 [95% CI 0.29-0.54], P=.40), composite outcome (SGA: adjusted OR 0.53 [95% CI 0.33-0.87] compared with AGA: adjusted OR 0.51 [95% CI 0.42-0.62], P=.85), need for mechanical ventilation (SGA: adjusted OR 0.60 [95% CI 0.39-0.91] compared with AGA: adjusted OR 0.54 [95% CI 0.46-0.64], P=.70), and severe brain injury (SGA: adjusted OR 0.42 [95% CI 0.22-0.84] compared with AGA: adjusted OR 0.39 [95% CI 0.30-0.51], P=.80). Similar reduction in the odds of neonatal death was observed in the subgroup of neonates with birth weight less than the fifth percentile for gestational age and sex: adjusted OR 0.38 (95% CI 0.16-0.92). CONCLUSION: For SGA preterm neonates, exposure to antenatal corticosteroids 1-7 days before birth was associated with decreased odds of neonatal mortality and morbidity similar in magnitude to that observed among AGA neonates.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".