Neonatal Morbidities among Moderately Preterm Infants with and without Exposure to Antenatal Corticosteroids

Abstract

Objective We aimed to compare the rates of “surfactant treated respiratory disease” and other neonatal morbidities among moderately preterm (MPT) infants exposed to no, partial, or a complete course of antenatal corticosteroids (ANS). Study Design This observational cohort study evaluated MPT infants (290/7–336/7 weeks’ gestational age), born between January 2012 and November 2013 and enrolled in the “MPT Registry” of the National Institute of Child Health and Human Development Neonatal Research Network. Results Data were available for 5,886 infants, including 676 with no exposure, 1225 with partial, and 3,985 with a complete course of ANS. Among no, partial, and complete ANS groups, respectively, there were significant differences in rates of delivery room resuscitation (4.1, 1.4, and 1.2%), surfactant-treated respiratory disease (26.5, 26.3, and 20%), and severe intracranial hemorrhage (3, 2, and 0.8%). Complete ANS course was associated with lower surfactant-treated respiratory disease, compared with partial ANS (odds ratio [OR] 0.62; 95% confidence interval [CI] 0.52–0.74), and no ANS groups (OR 0.52; 95% CI 0.41–0.66) on adjusted analysis. Conclusion In MPT infants, ANS exposure is associated with lower delivery room resuscitation, surfactant-treated respiratory disease, and severe intracranial hemorrhage; with the lowest frequency of morbidities associated with a complete course.

Use of antenatal corticosteroids among infants during gestational age at 24 to 31 weeks in 57 neonatal intensive care units of China: a cross-sectional study

“…The guideline only recommends ACS use for preterm birth at 28 to 34 weeks, with no recommendations for <28 weeks. What's more, compared with partial and no ACS, a complete course ACS was associated with the lowest incidences of morbidities [20] . Our rate of a complete ACS course was as low as 49.1% among infants with any ACS.…”

“…What's more, compared with partial and no ACS, a complete course ACS was associated with the lowest incidences of morbidities. [ 20 ] Our rate of a complete ACS course was as low as 49.1% among infants with any ACS. National guideline on management of preterm birth may need to be updated, and efforts are still needed to improve ACS administration in China.…”

Outcomes of Moderately Preterm Infants of Insulin-Dependent Diabetic Mothers

“…The potential association with higher respiratory support requirement at 28 postnatal days in those with abnormal cranial imaging was first reported in the original MPT cohort. 35 Abnormal cranial imaging was associated with chorioamnionitis and lower gestational age among MPT infants, while those who received antenatal steroids and delivered via cesarean section were at lower risk. 35 In our study, chorioamnionitis is unlikely to explain the association between IDP and PVL given that the rate of chorioamnionitis was similar for mothers with IDP and IBP.…”