Influence of Timing of Antenatal Corticosteroid Administration on Morbidity of Preterm Neonates

Morhart P, Gärtner J, Weiss C, Stumpfe F, Dammer U, Faschingbauer F, Fahlbusch F, Beckmann M, Kehl S (2022)

Publication Type: Journal article

Publication year: 2022

Journal

In Vivo International Institute of Anticancer Research (IIAR)

Book Volume: 36

Pages Range: 1777-1784

Journal Issue: 4

DOI: 10.21873/invivo.12891

Abstract

Background/Aim: We investigated the impact of the timing of antenatal corticosteroid (ACS) administration on the clinical outcome of preterm infants. Patients and Methods: Two hundred and fifty-five preterm infants between 28+0 and 34+0 weeks of gestation were retrospectively assigned to one of two groups: In the first group, ACS was given within 7 days before birth; the second group, did not receive ACS during that period. The primary outcome parameter was respiratory failure (defined by need for continuous positive airway pressure or mechanical ventilation) due to grade 1-4 respiratory distress syndrome (RDS). Secondary outcomes included the rates of intraventricular hemorrhage (IVH), periventricular leukomalacia, and necrotizing enterocolitis. Results: The rate of RDS was significantly higher in the no ACS group (40% vs. 62%, p=0.0009), especially of the more severe grades 24 (n=37 vs. n=48, p=0.0121). In addition, IVH (1% vs. 9%, p=0.0041) and neonatal infections (72% vs. 89%, p=0.0025) were significantly increased. Univariable and multivariable regression analyses showed a lower likelihood of RDS in the ACS group [odds ratio (OR)=0.295] in infants born closer to term (OR=0.907) and following preterm onset of labor (OR=0.495). Similarly, we observed a lower probability of IVH in the ACS group (OR=0.098), with a higher probability of occurrence of IVH in pre-eclampsia/HELLP syndrome (hemolysis, elevated liver enzyme levels, low platelet count) (OR=7.914). Conclusion: ACS treatment within the last 7 days before birth significantly reduced the risk of RDS and IVH in preterm. These data emphasize that the timing of ACS administration determines its success.

Authors with CRIS profile

Janis Gärtner Department of Obstetrics and Gynaecology Florian Stumpfe Department of Obstetrics and Gynaecology Fabian Fahlbusch Department of Paediatrics and Adolescent Medicine Matthias Beckmann Lehrstuhl für Geburtshilfe und Frauenheilkunde Sven Kehl Department of Obstetrics and Gynaecology

Involved external institutions

Ruprecht-Karls-Universität Heidelberg DE Germany (DE)

How to cite

APA:

Morhart, P., Gärtner, J., Weiss, C., Stumpfe, F., Dammer, U., Faschingbauer, F.,... Kehl, S. (2022). Influence of Timing of Antenatal Corticosteroid Administration on Morbidity of Preterm Neonates. In Vivo, 36(4), 1777-1784. https://doi.org/10.21873/invivo.12891

MLA:

Morhart, Patrick, et al. "Influence of Timing of Antenatal Corticosteroid Administration on Morbidity of Preterm Neonates." In Vivo 36.4 (2022): 1777-1784.

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