{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T22:30:34Z","timestamp":1778625034281,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T00:00:00Z","timestamp":1705190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate the effect of antenatal corticosteroids on newborn respiratory morbidity in twins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Regression discontinuity applied to population\u2010based birth registry data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>British Columbia, Canada, 2008\u20132018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Twin pregnancies admitted for birth between 31<jats:sup>+0<\/jats:sup> and 36<jats:sup>+6<\/jats:sup>\u2009weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>During our study period, Canadian clinical practice guidelines recommended antenatal corticosteroid administration for imminent preterm birth up to 33<jats:sup>+6<\/jats:sup>\u2009weeks. We used a logistic model to compare the predicted risks of our outcomes among pregnancies admitted for birth immediately before this clinical cut\u2010point (higher probability of exposure to antenatal corticosteroids) versus immediately after it (lower probability).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Our primary outcome was a composite of newborn respiratory distress or in\u2010hospital death. Our secondary outcome was a composite of newborn respiratory intervention or in\u2010hospital death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 2524 pregnancies (5035 liveborn twins), 47% of admissions before 34<jats:sup>+0<\/jats:sup>\u2009weeks of gestation were exposed to antenatal corticosteroids but only 4.2% of admissions after this cut\u2010point were exposed. The risk of newborn respiratory distress or in\u2010hospital mortality increased abruptly at 34<jats:sup>+0<\/jats:sup>\u2009weeks, corresponding to a protective effect of treatment (risk ratio [RR] 0.69, 95% CI 0.53\u20130.90; risk difference [RD]\u00a0\u221212 cases per 100 births, 95% CI \u221220 to \u22124.1). There was no clear evidence for or against an effect on newborn respiratory intervention or in\u2010hospital death (RR 0.89, 95% CI 0.70\u20131.13; RD \u22124.2 per 100, 95% CI \u221213 to +4.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings provide evidence for the effectiveness of antenatal corticosteroids in preventing adverse newborn respiratory outcomes in twins.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17754","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T03:24:04Z","timestamp":1705289044000},"page":"1064-1071","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Antenatal corticosteroids and newborn respiratory outcomes in twins: A regression discontinuity study"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6640-8672","authenticated-orcid":false,"given":"Peter 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Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer A.","family":"Hutcheon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004454.pub4"},{"key":"e_1_2_12_3_1","unstructured":"United States Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics Division of Vital Statistics.Natality Public\u2010Use Data 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