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
. 2023 Nov;308(5):1463-1471.
doi: 10.1007/s00404-022-06834-4. Epub 2022 Nov 10.

Antenatal corticosteroids and outcomes of small for gestational age infants born at 24-31 gestational weeks: a population-based propensity score matching analysis

Takafumi Ushida  1   2 , Masahiro Nakatochi  3 , Yumiko Kobayashi  4 , Noriyuki Nakamura  5 , Kazuya Fuma  5 , Yukako Iitani  5 , Kenji Imai  5 , Yoshiaki Sato  6 , Masahiro Hayakawa  6 , Hiroaki Kajiyama  5 , Tomomi Kotani  5   7 ; Neonatal Research Network of Japan
Affiliations

Antenatal corticosteroids and outcomes of small for gestational age infants born at 24-31 gestational weeks: a population-based propensity score matching analysis

Takafumi Ushida et al. Arch Gynecol Obstet. 2023 Nov.

Abstract

Purpose: To evaluate the effect of antenatal corticosteroid (ACS) treatment on neonatal outcomes in small for gestational age (SGA) infants born at 24-31 gestational weeks compared with non-SGA infants.

Methods: A population-based retrospective study was conducted that analyzed clinical data from the Neonatal Research Network of Japan database, which enrolls neonates born at < 32 gestational weeks and weighing 1500 g or less (n = 22,414). Propensity score matching (with the ratio of ACS to no-ACS groups of 1:1) was performed in SGA (n = 7028) and non-SGA (n = 15,386) infants, respectively. Univariate logistic and interaction analyses were performed to compare the short-term neonatal outcomes of infants with and without ACS treatment in utero.

Results: In the SGA and non-SGA infants, ACS treatment significantly reduced in-hospital mortality (odds ratio 0.67 95% confidence interval [0.50-0.88] and 0.62 [0.50-0.78], respectively), respiratory distress syndrome (0.77 [0.69-0.87] and 0.63 [0.58-0.68], respectively), and composite adverse outcomes (0.73 [0.58-0.91] and 0.57 [0.50-0.65], respectively). ACS treatment also significantly reduced intraventricular hemorrhage (grade III/IV), periventricular leukomalacia, and sepsis in the non-SGA infants, but not in the SGA infants. However, interaction analyses revealed no significant differences between the SGA and non-SGA infants in the efficacy of ACS treatment on short-term outcomes except for respiratory distress syndrome.

Conclusions: ACS treatment was associated with beneficial effects on mortality, respiratory distress syndrome, and adverse composite outcomes in extremely and very preterm SGA infants, with similar efficacy on all neonatal outcomes except for respiratory distress syndrome observed in the non-SGA infants.

Keywords: Antenatal corticosteroids; Neonatal morbidity; Neonatal mortality; Preterm infants; Small for gestational age.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Madden JV, Flatley CJ, Kumar S (2018) Term small-for-gestational-age infants from low-risk women are at significantly greater risk of adverse neonatal outcomes. Am J Obstet Gynecol 218(5):525.e1-525.e9 - PubMed - DOI
    1. Vollmer B, Edmonds CJ (2019) School age neurological and cognitive outcomes of fetal growth retardation or small for gestational age birth weight. Front Endocrinol 10:186 - DOI
    1. Crispi F, Miranda J, Gratacos E (2018) Long-term cardiovascular consequences of fetal growth restriction: biology, clinical implications, and opportunities for prevention of adult disease. Am J Obstet Gynecol 218(2s):S869-s879 - PubMed - DOI
    1. Ray JG, Park AL, Fell DB (2017) Mortality in infants affected by preterm birth and severe small-for-gestational age birth weight. Pediatrics 140(6):e20171881 - PubMed - DOI
    1. Paixao ES et al (2021) Risk of mortality for small newborns in Brazil, 2011–2018: a national birth cohort study of 17.6 million records from routine register-based linked data. Lancet Reg Health Americas 3:100045 - PubMed - DOI

Substances

LinkOut - more resources