The Effect of Antenatal Corticosteroids on Survival in Extreme Prematurity [22D]
Bibliographic record
Abstract
INTRODUCTION: The decision to administer antenatal corticosteroids (ACS) to women who in preterm labor prior to 25 weeks remains controversial. Recent studies suggest reduction in morbidity and mortality with administration of ACS prior to 25 weeks. Our primary objective was to evaluate the effect of ACS on survival in extreme prematurity. Our secondary objective was to assess the effect of ACS on morbidities such as respiratory distress syndrome (RDS), chronic lung disease (CLD), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC). METHODS: A retrospective chart review was conducted on patients who delivered between gestational ages (GA) of 23-25 weeks at a large tertiary academic center between Jan 1st 2003 and Dec 31st 2017. Multiple gestation pregnancies, terminations, and patients who declined neonatal resuscitation were excluded. Logistic regression was used to assess the effect of ACS treatment on neonatal mortality and morbidity, while controlling for maternal age, GA, and maternal complications. RESULTS: A total of 407 singleton births met criteria, with 394 (96.8%) mothers receiving at least one dose of ACS and 13 (3.2%) receiving no ACS. Neonatal mortality was significantly lower for infants exposed to a full course of ACS (OR=0.30, 95% CI=0.09-0.99). Administration of ACS did not show any significant effect on morbidity, but did show a reduction in IVH (OR=0.63, 95% CI=0.15-2.64), increase odds of CLD (OR=1.51, 95% CI=0.43-5.30), and NEC (OR=1.14, 95% CI=0.22-5.93). CONCLUSION: Treatment with ACS for infants born at 23 to 25 weeks gestation was associated with a lower rate of neonatal mortality. No significant effect on morbidity was demonstrated.
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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 | 0.000 | 0.000 |
| 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".