Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Jun;110(6):1795-1802.
doi: 10.1111/apa.15772. Epub 2021 Feb 15.

Antenatal corticosteroid therapy is associated with a lower risk of cystic periventricular leukomalacia

Calanit Hershkovich Shporen  1 , Brian Reichman  2   3 , Inna Zaslavsky-Paltiel  2 , Liat Lerner-Geva  2   3 , Orna Flidel-Rimon  1   4 ; Israel Neonatal Network
Affiliations
Observational Study

Antenatal corticosteroid therapy is associated with a lower risk of cystic periventricular leukomalacia

Calanit Hershkovich Shporen et al. Acta Paediatr. 2021 Jun.

Abstract

Aim: To evaluate the association of antenatal corticosteroids (ACS) therapy on the risk for cystic periventricular leukomalacia (c-PVL) in very low birth weight (VLBW), very preterm infants, whilst accounting for the occurrence of major neonatal morbidities; sepsis, necrotising enterocolitis, intraventricular haemorrhage and bronchopulmonary dysplasia.

Methods: Population-based observational cohort study applying data collected by the Israel national VLBW infant database from 1995-2016.

Results: Cystic PVL was diagnosed in 692 (6.8%) of the 10,170 study infants. Among 7522 infants exposed to ACS, the rate of c-PVL was 5.4%, compared to 10.7% among those not exposed (p < 0.0001). ACS was associated with significantly lower odds for c-PVL (Odds Ratio [OR] 0.69, 95% confidence interval [CI] 0.57-0.84). In subgroup analyses, excluding infants with one or more morbidities the rates of c-PVL ranged from 2.7% to 5.4% among infants exposed to ACS compared to 5.6% to 10.7% in those not exposed (all p < 0.0001). ACS was associated with significantly lower OR's for c-PVL in all subgroups, ranging from 0.52 (95% CI 0.40-0.66) to 0.62 (95% CI 0.50-0.77).

Conclusion: Infants exposed to ACS had a significantly lower risk of c-PVL. Subgroup analyses excluding infants with major neonatal comorbidities showed a consistent reduction of 40%-50% in the risk for c-PVL following ACS therapy.

Keywords: antenatal corticosteroids; bronchopulmonary dysplasia; cystic periventricular leukomalacia; intraventricular haemorrhage; necrotising enterocolitis; neonatal morbidities; sepsis.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

REFERENCES

    1. Antenatal corticosteroids revisited: repeat courses - National Institutes of Health Consensus Development Conference Statement, August 17-18, 2000. National Institutes of Health Consensus Development Panel Obstet Gynecol. 2001;98:144-150.
    1. Roberts D, Brown J, Medly N, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2017;3(3):CD004454.
    1. Canterino JC, Verma U, Visintainer PF, Elimian A, Klein SA, Tejani N. Antenatal steroids and neonatal periventricular leukomalacia. Obstet Gynecol. 2001;97:135-139.
    1. Agarwal R, Chiswick ML, Rimmer S, et al. Antenatal steroids are associated with a reduction in the incidence of cerebral white matter lesions in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed. 2002;86:96-101.
    1. Chawla S, Natarajan G, Shankaran S, et al. National Institute of Child Health and Human Development Neonatal Research Network. Association of neurodevelopmental outcomes and neonatal morbidities of extremely premature infants with differential exposure to antenatal steroids. JAMA Pediatr. 2016;170:1164-1172.

Publication types

Substances

LinkOut - more resources