Consortium for the Study of Pregnancy Treatments (Co-OPT): An international birth cohort to study the effects of antenatal corticosteroids

Co Opt Consortium, Emily Frier, Chun Lin, Rebecca M. Reynolds, Mika Gissler, Marius Lahti-Pulkkinen, Sarah Stock

Tutkimustuotos: ArtikkelijulkaisuArtikkeliTieteellinenvertaisarvioitu

Abstrakti

Background
Antenatal corticosteroids (ACS) are widely prescribed to improve outcomes following preterm
birth. Significant knowledge gaps surround their safety, long-term effects, optimal timing
and dosage. Almost half of women given ACS give birth outside the “therapeutic
window” and have not delivered over 7 days later. Overtreatment with ACS is a concern, as
evidence accumulates of risks of unnecessary ACS exposure.
Methods
The Consortium for the Study of Pregnancy Treatments (Co-OPT) was established to
address research questions surrounding safety of medications in pregnancy. We created an
international birth cohort containing information on ACS exposure and pregnancy and neonatal
outcomes by combining data from four national/provincial birth registers and one hospital
database, and follow-up through linked population-level data from death registers and
electronic health records.
Results and discussion
The Co-OPT ACS cohort contains 2.28 million pregnancies and babies, born in Finland, Iceland,
Israel, Canada and Scotland, between 1990 and 2019. Births from 22 to 45 weeks’
gestation were included; 92.9% were at term (� 37 completed weeks). 3.6% of babies were
exposed to ACS (67.0% and 77.9% of singleton and multiple births before 34 weeks,
respectively). Rates of ACS exposure increased across the study period. Of all ACSexposed
babies, 26.8% were born at term. Longitudinal childhood data were available for
1.64 million live births. Follow-up includes diagnoses of a range of physical and mental disorders
from the Finnish Hospital Register, diagnoses of mental, behavioural, and neurodevelopmental
disorders from the Icelandic Patient Registers, and preschool reviews from the
Scottish Child Health Surveillance Programme. The Co-OPT ACS cohort is the largest international
birth cohort to date with data on ACS exposure and maternal, perinatal and childhood
outcomes. Its large scale will enable assessment of important rare outcomes such as
perinatal mortality, and comprehensive evaluation of the short- and long-term safety and
efficacy of ACS.
Alkuperäiskielienglanti
Artikkelie0282477
LehtiPLoS One
Vuosikerta18
Numero3
Sivumäärä27
ISSN1932-6203
DOI - pysyväislinkit
TilaJulkaistu - 2023
OKM-julkaisutyyppiA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä, vertaisarvioitu

Tieteenalat

  • 515 Psykologia

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