Small for Gestational Age in Late Preterm Deliveries - The Impact of Antenatal Corticosteroids on Perinatal Outcome

Abstract

Purpose The aim of this study is to evaluate the impact of antenatal corticosteroids (ACS) on late preterm small for gestational age neonates. Methods A retrospective cohort study of all women, carrying a singleton gestation, who had late preterm delivery (34 + 0–36 + 6, gestational weeks) of small for gestational age neonates, in a single, tertiary, university-affiliated medical center (July 2012- December 2017). Exclusion criteria included: birth weight above the 10th percentile, termination of pregnancy and intrauterine fetal death. Outcomes were compared between those who were treated with ACS prior to delivery and those who did not receive ACS. The primary outcome was neonatal composite outcome which included: neonatal intensive care unit admission, respiratory distress syndrome, mechanical ventilation and transient tachypnea of the newborn. Results Overall, 228 women met inclusion criteria.102 (44.7%) received ACS and 126 did not (55.3%). Birth weight among non-ACS group was significantly higher (1880.38 ± 171.54 vs 1774.84 ± 229.15 grams p < 0.001). Rates of NICU and Jaundice requiring phototherapy were higher among the ACS group (53.92% vs 31.74%, p = 0.01 and 12.74% vs 5.55%, p = 0.05, respectively). Composite neonatal outcome was significantly higher among the ACS group (53.92% vs 32.53%, OR 2.42, CI 1.41–4.15, p = 0.01). After adjustment for potential confounders, using multivariate regression analysis this association remained significant (OR 2.38, 95% CI 1.39–4.10, p = 0.002). Conclusion Our findings suggest that ACS delivered during pregnancy did not improve respiratory adverse outcome for SGA neonates born in late preterm. ACS in this specific cohort might be associated with worse outcome than those not treated with ACS.