The Benefits and Risks of Multiple Courses of Antenatal Corticosteroid Therapy in Patients with Preterm Premature Rupture of Membranes.
- Author:
Soon Ha YANG
1
;
Su Ran CHOI
;
Suk Joo CHOI
;
Ji Soo LEE
;
Yong Soo SEO
;
Jong Hwa KIM
Author Information
1. Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Antenatal corticosteroids therapy;
Multiple courses;
Preterm premature rupture of membranes;
Repiratory distress syndrome;
Clinical chorioamnionitis
- MeSH:
Adrenal Cortex Hormones;
Chorioamnionitis;
Confounding Factors (Epidemiology);
Female;
Humans;
Incidence;
Infant, Newborn;
Logistic Models;
Membranes*;
Pregnancy;
Retrospective Studies;
Risk Assessment*;
Rupture*
- From:Korean Journal of Obstetrics and Gynecology
2004;47(2):250-257
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: This study was performed to determine the benefits and risks of multiple courses of corticosteroids in patients with preterm premature rupture of membranes (PPROM). METHODS: We retrospectively evaluated the pregnancy and neonatal outcomes for women of singleton pregnancy with PPROM admitted at 24-32 weeks of gestation. Patients were categorized into 3 groups according to antenatal corticosteroids exposure: (1) non-user group, (2) single-course group, (3) multiple-course group. Chi-square test, analysis of variances, Kruskal-Wallis test, and multiple logistic regression analysis were used for statistical analyses. RESULTS: A total of 170 patients were included, with 50 in non-use group, 76 in single-course group, and 44 in multiple-course group. Univariate analyses showed that clinical chorioamnionitis occurred in the highest incidence in multiple-course group (x2=6.20, p<0.05) and the decreased incidence of RDS in multiple-course group (x2=10.0, p<0.01). Multiple logistic regression analyses demonstrated that no significant association was found after adjustment of confounding variables (odds ratio=0.28, p=0.063) whereas multiple courses of corticosteroids were independently associated with clinical chorioamnionitis (odds ratio=13.15, p=0.025). CONCLUSION: Multiple courses of antenatal corticosteroids therapy did not reduce the incidence of RDS in neonates and were associated with increased risk of clinical chorioamnionitis in patients with PPROM.
