Association Between Antenatal Corticosteroid Administration-to-Birth Interval and Outcomes of Preterm Neonates
Bibliographic record
Abstract
OBJECTIVE: To assess the association between antenatal corticosteroid administration-to-birth interval and outcomes. METHODS: In this retrospective cohort study, data on singleton neonates born between 24 0/7 and 33 6/7 weeks of gestation and admitted to tertiary neonatal units in Canada during 2010-2012 were obtained from the Canadian Neonatal Network. Neonatal outcomes were compared among four groups based on the interval between antenatal corticosteroid administration and birth: no antenatal corticosteroids, partial antenatal corticosteroids (less than 24 hours before birth), antenatal corticosteroids 1-7 days before birth, and antenatal corticosteroids greater than 7 days before birth. Composite outcome was defined as any of neonatal mortality, bronchopulmonary dysplasia, grade 3-4 intraventricular hemorrhage, periventricular leukomalacia, or stage 3 or higher retinopathy. RESULTS: Of 6,870 eligible neonates, 1,378 (20%) received no antenatal corticosteroids; 1,473 (21%) received partial antenatal corticosteroids; 2,721 (40%) received antenatal corticosteroids 1-7 days before birth; and 1,298 (19%) received antenatal corticosteroids greater than 7 days before birth. The odds of the composite adverse outcome were significantly higher in all groups compared with neonates who received antenatal corticosteroids 1-7 days before birth (no antenatal corticosteroids: adjusted odds ratio [OR] 2.12, 95% confidence interval [CI] 1.69-2.65; partial antenatal corticosteroids: adjusted OR 1.48, 95% CI 1.22-1.80; and antenatal corticosteroids at greater than 7 days: adjusted OR 1.46, 95% CI 1.20-1.77). Similar findings were observed with respect to neonatal mortality (no antenatal corticosteroids: adjusted OR 2.56, 95% CI 1.83-3.59; partial antenatal corticosteroids: adjusted OR 1.59, 95% CI 1.16-2.18; and antenatal corticosteroids at greater than 7 days: adjusted OR 1.40, 95% CI 1.00-1.97). CONCLUSION: Antenatal corticosteroids had maximum benefit when given between 1 and 7 days before birth. LEVEL OF EVIDENCE: II.
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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 | 0.007 |
| 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 | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".