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
. 2022 Jul-Aug;36(4):1777-1784.
doi: 10.21873/invivo.12891.

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

Patrick Morhart  1 , Janis Gärtner  2 , Christel Weiss  3 , Florian Matthias Stumpfe  2 , Ulf Dammer  2 , Florian Faschingbauer  2 , Fabian B Fahlbusch  4 , Matthias W Beckmann  2 , Sven Kehl  2
Affiliations

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

Patrick Morhart et al. In Vivo. 2022 Jul-Aug.

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.

Keywords: Antenatal corticosteroids; RDS; morbidity; mortality; preterm birth; respiratory distress syndrome.

PubMed Disclaimer

Conflict of interest statement

The Authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Harrison MS, Goldenberg RL. Global burden of prematurity. Semin Fetal Neonatal Med. 2016;21(2):74–79. doi: 10.1016/j.siny.2015.12.007. - DOI - PubMed
    1. Torchin H, Ancel PY. Epidemiology and risk factors of preterm birth. J Gynecol Obstet Biol Reprod (Paris) 2016;45(10):1213–1230. doi: 10.1016/j.jgyn.2016.09.013. - DOI - PubMed
    1. Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972;50(4):515–525. - PubMed
    1. Ehret DEY, Edwards EM, Greenberg LT, Bernstein IM, Buzas JS, Soll RF, Horbar JD. Association of antenatal steroid exposure with survival among infants receiving postnatal life support at 22 to 25 weeks’ gestation. JAMA Netw Open. 2018;1(6):e183235. doi: 10.1001/jamanetworkopen.2018.3235. - DOI - PMC - PubMed
    1. Räikkönen K, Gissler M, Kajantie E. Associations between maternal antenatal corticosteroid treatment and mental and behavioral disorders in children. JAMA. 2020;323(19):1924–1933. doi: 10.1001/jama.2020.3937. - DOI - PMC - PubMed

Substances