Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction.
- Author:
Yoo Jinie KIM
1
;
Sung Hwan CHOI
;
Sohee OH
;
Jin A SOHN
;
Young Hwa JUNG
;
Seung Han SHIN
;
Chang Won CHOI
;
Ee Kyung KIM
;
Han Suk KIM
;
Beyong Il KIM
;
Jin A LEE
Author Information
- Publication Type:Original Article
- Keywords: Prenatal care; Steroids; Fetal growth retardation; Premature infant; Outcome assessment (health care)
- MeSH: Adrenal Cortex Hormones*; Apgar Score; Birth Weight; Bronchopulmonary Dysplasia; Female; Fetal Growth Retardation; Humans; Hypertension, Pregnancy-Induced; Hypotension; Infant; Infant, Newborn*; Infant, Premature; Logistic Models; Mortality; Nitric Oxide; Obstetric Labor, Premature; Odds Ratio; Outcome Assessment (Health Care); Parturition; Pregnancy; Prenatal Care; Retrospective Studies; Seoul; Steroids
- From:Neonatal Medicine 2018;25(4):161-169
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: We assessed the influence of antenatal corticosteroid (ACS) on the inhospital outcomes of intrauterine growth restriction (IUGR) infants. METHODS: A retrospective study was conducted with singletons born at 23⁺⁰ to 33⁺⁶ weeks of gestation at Seoul National University Hospital from 2007 to 2014. We compared clinical outcomes between infants who received ACS 2 to 7 days before birth (complete ACS), at < 2 or >7 days (incomplete ACS), and those who did not receive ACS in IUGR and AGA infants. Multivariate logistic regression using Firth's penalized likelihood was performed. RESULTS: 304 neonates with 91 IUGR neonates were eligible. Among AGA neonates, mortality (adjusted odds ratio [aOR], 0.13; 95% confidence interval [CI], 0.02 to 0.78), hypotension within 7 postnatal days (aOR, 0.20; 95% CI, 0.06 to 0.64), and severe bronchopulmonary dysplasia (BPD) or death (aOR, 0.24; 95% CI, 0.07 to 0.77) were lower in complete ACS group after adjusting for pregnancy induced hypertension and uncontrolled preterm labor. Mortality (aOR, 0.18; 95% CI, 0.04 to 0.78), hypotension (aOR, 0.26; 95% CI, 0.09 to 0.70), and severe BPD or death (aOR, 0.33; 95% CI, 0.12 to 0.92) were also lower in the incomplete ACS group. Among IUGR infants, after adjusting for birth weight and 5-minute Apgar score, inhaled nitric oxide use within 14 postnatal days was lower in both complete ACS (aOR, 0.07; 95% CI, 0.01 to 0.67) and incomplete ACS (aOR, 0.04; 95% CI, 0.01 to 0.37) groups. CONCLUSION: ACS was not effective in reducing morbidities in IUGR preterm infants.
