Antenatal Corticosteroid Use in Twin Pregnancies: A Systematic Review and Meta-analysis.
Carolina Alves Felippe, Sinrraim Dos Santos Chaves Ruiz, Rebeca Ferreira de Souza et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effects of antenatal corticosteroid (ACS) exposure in twin pregnancies, analyzing data from 16 studies involving 18,367 neonates. The study found no significant reduction in neonatal mortality (RR 0.77, 95% CI 0.59-1.01) or respiratory distress syndrome, but identified increased risks of neonatal hypoglycemia, supplemental oxygen requirement, and NICU admission associated with ACS exposure.
Key findings
- ACS exposure was not significantly associated with a reduction in neonatal mortality (RR 0.77, 95% CI 0.59-1.01).
- Increased risk of neonatal hypoglycemia was observed (RR 1.80, 95% CI 1.30-2.51).
- ACS exposure was linked to a higher requirement for supplemental oxygen (RR 1.72, 95% CI 1.07-2.74).
- NICU or special care unit admission was more frequent with ACS exposure (RR 1.33, 95% CI 1.07-1.64).
Why it matters
Understanding the benefit-risk profile of antenatal corticosteroids in twin pregnancies is crucial for clinicians, as the findings suggest that ACS may not improve neonatal outcomes and could increase certain risks, impacting clinical decision-making.
What to keep in mind
The overall certainty of evidence was moderate to low, which may affect the reliability of the findings.