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Comparison of respiratory distress syndrome amongst preterm twins (28-34 Weeks) born within and after two weeks of completion of single antenatal corticosteroid course: A bidirectional cohort study

Monisha J Arulalan
Monisha J Arulalan
, 
Gowri Dorairajan
Gowri Dorairajan
, 
Nivedita Mondal
Nivedita Mondal
 et 
Palanivel Chinnakali
Palanivel Chinnakali
   | 18 avr. 2022
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Article Category: Original Article
Publié en ligne: 18 avr. 2022
Pages: 260 - 268
Reçu: 26 nov. 2021
Accepté: 20 janv. 2022
DOI: https://doi.org/10.34763/jmotherandchild.20212504.d-21-00034
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© 2022 Monisha J Arulalan et. al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Flow chart of the study.
Flow chart of the study.

Propensity-matched scoring

Outcome Grouping Matched Pairs Adjusted Relative Risk (95% CIa) P-value
RDSb <14 vs >14 days Grp A (n=180) ref
Grp B (n=180) 1.13 (0.93-1.33) 0.231
NDc <14 vs >14 days Grp A (n=180) ref
Grp B (n=180) 2.0 (1.03-3.88) 0.017
RDS <7 vs >7 days Grp A (n=161) ref
Grp B (n=161) 1.04 (0.84-1.28) 0.722
ND <7 vs >7 days Grp A (n=161) ref
Grp B (n=161) 1.85 (0.97-3.50) 0.052

Maternal demographic and obstetrics variables in the two groups

Baseline maternal characteristics <14 Days Group A >14 Days Group B
(N=134) (N=134)
AGE years 19-25 years 62(46.27%) 47(35.07%) 0.017a
26-34 years 66(49.25%) 69(51.49%) (𝑥2 = 8.13)
≥35 years 6(4.48%) 18(13.43%)
EDUCATION Illiterate 2(1.4%) 1(0.7%) 0.531 (𝑥2 =7.05)
Primary 16(11.9%) 15(11.5%)
Middle 53(39.5%) 50(37.3%)
Higher 49 (36.5%) 49(36.6%)
Graduation 14 (10.4%) 19(14.2%)
PARITY Primigravida 101(75.67%) 98 (73.13%) 0.675 (𝑥2 =0.17)
Multigravida 33 (24.33%) 36 (26.87%)
TYPE OF STEROID Betamethasone 246 196 <0.0001 a (𝑥2 = 32.25)
Dexamethasone 22 72
MODE OF CONCEPTION SPONTANEOUS (n=141) 83(61.94%) 58(43.28%) 0.002* (𝑥2 = 17.25)
ASSISTED (n=127) 51 (40.2%) 76 (59.8%)
CHORIONICITY Monochorionic (n=58) 26(19.40%) 32(23.88%) 0.373 (𝑥2 =0.79)
Dichorionic (n=210) 108(80.60%) 102(76.12%)
COMORBIDITY HTDb (n=58) 26(19.40%) 32(23.88%) 0.013 a 𝑥2 =(8.88)
Preterm premature rupture of membranes 63(23.5%) 17(6.3%) <0.00001 a (𝑥2 = 31.5)
GESTATIONAL AGE at DELIVERY Mean ± SDc 31.5(±2.09) 32.6 (± 1.75) <0.001 a
28-29+6(n=52) 38(28.36%) 14(10.45%) <.001 a (𝑥2 =40.716)
30-32+6(n=68) 39(29.10%) 29(21.64%)
33-34 (n=148) 57(42.54%) 91(67.91%)
MODE OF DELIVERY Caesarean (n=232) 95(35.4%) 137(51.1%) <0.001 a(𝑥2 =13.40)
Vaginal (n=304) 173(64.6%) 131(48.9%)

Multivariable regression analysis of factors influencing respiratory distress syndrome and neonatal deaths

Variable (Reference Group) RDS (respiratory distress syndrome) Neonatal Deaths
ARRa (95% CIb) P-value ARRa (95% CIb) P-value
Steroid Group B (Ref-GroupA) 1.09 (0.84-1.4) 0.510 1.06 (0.620-1.8) 0.810
Twin Order 2 (Ref-Twin order1) 1.012 (0.790-1.2) 0.921 1.20 (0.72-2.00) 0.484
Twin Dichorionic (Ref-monochrionic) 1.01 (0.744-1.3) 0.920 1.11 (0.53- 2.30) 0.778
Period of Gestation(weeks) (Ref-33-33+6weeks) 28-29+6 1.84 (1.17-2.8) 0.008c 1.75 (0.48-6.3) 0.392
30-32+6 1.75 (1.1-2.5) 0.004c 1.49 (0.405-5.52) 0.545
Caesarean Delivery (Ref-Vaginal Delivery) - 1.28 (0.95-1.7) 0.102 0.987 (0.454-2.14) 0.975
Birth Weight (Ref- ≥ 2kg) <1 kg 5.60 (2.7-11.2) 0.0011 c 26.06 (2.37-285.5) 0.008 c
1-1.49 kg 5.23 (2.8-9.6) 0.0001 c 6.30 (0.619-64.09) 0.120
1.5-1.99 kg 2.8 (1.5-5) 0.001 c 0.716 (0.434-11.82) 0.816
1 min Apgar< (Ref- I min Apgar score>7) 2.46 (0.81-7.41) 0.110
Sex Male (Ref- Female) 1.07 (0.62-1.82) 0.802
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Medicine, Clinical Medicine, Pediatrics and Juvenile Medicine, Paediatric Haematology and Oncology, Public Health
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