Obstet Gynecol Sci.  2018 Jan;61(1):7-13. 10.5468/ogs.2018.61.1.7.

Antenatal corticosteroids and outcomes of preterm small-for-gestational-age neonates in a single medical center

Affiliations
  • 1Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. biondi77@hanmail.net

Abstract


OBJECTIVE
This study investigated the effect of an antenatal corticosteroid (ACS) in preterm small-for-gestational-age (SGA) neonate.
METHODS
This study was a retrospective cohort study. We compared women who received ACS with unexposed controls and evaluated neonatal complications among those having a singleton SGA neonate born between 29 and 34 complete gestational weeks. The neonates born after 32 weeks of gestation were divided into subgroups. Multivariable logistic regression analysis was performed.
RESULTS
A total 82 of the preterm infants met inclusion criteria; 57 (69.5%) were born after 32 weeks of gestation. There were no significant differences in terms of mechanical ventilation, seizure, intracranial hemorrhage, retinopathy of prematurity, necrotizing enterocolitis, feeding difficulty, and neonatal mortality between infants whose mothers received ACS ant those whose mothers did not (all P>0.05). However, newborns whose mothers received ACS exhibited a significantly increased risk of developing respiratory distress syndrome (RDS) (adjusted odds ratio [aOR], 3.271; 95% confidence interval [CI], 1.038-10.305; P=0.043). In case of neonates born beyond 32 weeks of gestation, the risk of neonatal hypoglycemia was significantly higher in women receiving ACS after controlling for confounding factors (aOR, 5.832; 95% CI, 1.096-31.031; P=0.039).
CONCLUSION
ACS did not improve neonatal morbidities, in SGA neonates delivered between 29 and 34 gestational weeks. Rather, ACS could increase the risk of RDS. In cases of SGA neonate delivered between 32 and 34 complete gestational weeks, the risk of hypoglycemia was significantly increased. The use of ACS in women with preterm SGA infants needs to be evaluated further, especially after 32 weeks' gestation.

Keyword

Antenatal corticosteroids; Premature birth; Infant; Fetal growth retardation; Respiratory distress syndrome, newborn

MeSH Terms

Adrenal Cortex Hormones*
Ants
Cohort Studies
Enterocolitis, Necrotizing
Female
Fetal Growth Retardation
Humans
Hypoglycemia
Infant
Infant Mortality
Infant, Newborn*
Infant, Premature
Intracranial Hemorrhages
Logistic Models
Mothers
Odds Ratio
Pregnancy
Premature Birth
Respiration, Artificial
Respiratory Distress Syndrome, Newborn
Retinopathy of Prematurity
Retrospective Studies
Seizures
Adrenal Cortex Hormones

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