Antenatal corticosteroids and outcomes of preterm small-for-gestational-age neonates in a single medical center
- Author:
Woo Jeng KIM
1
;
Young Sin HAN
;
Hyun Sun KO
;
In Yang PARK
;
Jong Chul SHIN
;
Jeong Ha WIE
Author Information
- Publication Type:Original Article
- Keywords: Antenatal corticosteroids; Premature birth; Infant; Fetal growth retardation; Respiratory distress syndrome, newborn
- MeSH: Adrenal Cortex Hormones; Ants; Cohort Studies; Enterocolitis, Necrotizing; Female; Fetal Growth Retardation; Humans; Hypoglycemia; Infant; Infant Mortality; Infant, Newborn; Infant, Premature; Intracranial Hemorrhages; Logistic Models; Mothers; Odds Ratio; Pregnancy; Premature Birth; Respiration, Artificial; Respiratory Distress Syndrome, Newborn; Retinopathy of Prematurity; Retrospective Studies; Seizures
- From:Obstetrics & Gynecology Science 2018;61(1):7-13
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: This study investigated the effect of an antenatal corticosteroid (ACS) in preterm small-for-gestational-age (SGA) neonate. METHODS: This study was a retrospective cohort study. We compared women who received ACS with unexposed controls and evaluated neonatal complications among those having a singleton SGA neonate born between 29 and 34 complete gestational weeks. The neonates born after 32 weeks of gestation were divided into subgroups. Multivariable logistic regression analysis was performed. RESULTS: A total 82 of the preterm infants met inclusion criteria; 57 (69.5%) were born after 32 weeks of gestation. There were no significant differences in terms of mechanical ventilation, seizure, intracranial hemorrhage, retinopathy of prematurity, necrotizing enterocolitis, feeding difficulty, and neonatal mortality between infants whose mothers received ACS ant those whose mothers did not (all P>0.05). However, newborns whose mothers received ACS exhibited a significantly increased risk of developing respiratory distress syndrome (RDS) (adjusted odds ratio [aOR], 3.271; 95% confidence interval [CI], 1.038–10.305; P=0.043). In case of neonates born beyond 32 weeks of gestation, the risk of neonatal hypoglycemia was significantly higher in women receiving ACS after controlling for confounding factors (aOR, 5.832; 95% CI, 1.096–31.031; P=0.039). CONCLUSION: ACS did not improve neonatal morbidities, in SGA neonates delivered between 29 and 34 gestational weeks. Rather, ACS could increase the risk of RDS. In cases of SGA neonate delivered between 32 and 34 complete gestational weeks, the risk of hypoglycemia was significantly increased. The use of ACS in women with preterm SGA infants needs to be evaluated further, especially after 32 weeks' gestation.
