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Re: What's next-steroids after 34 w From: Dr Eberhard Lisse (el@lisse.NA) Wed Apr 30 00:28:43 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr Eberhard W Lisse: "Re: Group Urges Ban on Medical Giveaways" Previous message: Ronald Ainsworth: "Re: Group Urges Ban on Medical Giveaways" In reply to: JD Stewart,MD: "Re: What's next-steroids after 34 w" Next in thread: JD Stewart,MD: "Re: What's next-steroids after 34 w" Reply: JD Stewart,MD: "Re: What's next-steroids after 34 w" Is anything you say encumbered by evidence? el on 4/29/08 7:35 PM JD Stewart,MD said the following: > Logic can prevail, if we allow...big studies/ Meta analyses showing > a smaller head circ and 5% less average body weight have a fatal > flaw inherent in the study populations in that they do not account > for factors we know have such an effect- namely smoking ( cited at > an average 8 ozs less at birth at term), maternal weight gain, drug > abuse, use, work patterns, history of preterm births ..etc. Some > have even included twins and anomalous babies. > > No long term growth deficits or developmental aberrations in all > these children of moms with asthma or allergies or CT disorders who > have been on large repeated doses of steroids have been shown in the > last 40 years... > > Steroids work every day, just as they will continue to work until we > are buried. The problem is a statistical matter (nearly impossible > to gather enough data to show an p<.o5 improvement over a baseline > 98-99% survival without problems..) not a biochemical or > physiologic process that suddenly stops working on a magic date. > > Re: Should we dose/ redose at 34-35-even 36w? Ask yourself- What > does it hurt? How sure can any of us be about gestational dating? > If the baby does come "late preterm" and is that 1-2% with problems, > who is going to defend your "not recognizing her risk for delivering > early and and failing to offer > steroids/progesterone/cerclage/smoking cessation/ aromatherapy > SOONER?" > > Why tocolyse at 34-35-36 if doing so will not improve the outcome > (unless you give steroids...)? > > Questions for article below: Hospitalization/ off work/ tocolysis > for weeks has no economic cost? Next message: Dr Eberhard W Lisse: "Re: Group Urges Ban on Medical Giveaways" Previous message: Ronald Ainsworth: "Re: Group Urges Ban on Medical Giveaways" In reply to: JD Stewart,MD: "Re: What's next-steroids after 34 w" Next in thread: JD Stewart,MD: "Re: What's next-steroids after 34 w" Reply: JD Stewart,MD: "Re: What's next-steroids after 34 w"

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