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Am J Perinatol. 2018 Oct;35(12):1213-1221. doi: 10.1055/s-0038-1642059. Epub 2018 Apr 27.

Neonatal Morbidities among Moderately Preterm Infants with and without Exposure to Antenatal Corticosteroids.

Author information

1
Department of Pediatrics, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan.
2
Biostatistics and Epidemiology Division, RTI International, Rockville, Maryland.
3
Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio.
4
Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa.
5
Department of Pediatrics, Women and Infants' Hospital of Rhode Island, Providence, Rhode Island.
6
Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, California.
7
Department of Pediatrics, University of Rochester, Rochester, New York.
8
McGovern Medical School at the University of Texas Health Science Center, Houston, Texas.
9
Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Abstract

OBJECTIVE:

 We aimed to compare the rates of "surfactant treated respiratory disease" and other neonatal morbidities among moderately preterm (MPT) infants exposed to no, partial, or a complete course of antenatal corticosteroids (ANS).

STUDY DESIGN:

 This observational cohort study evaluated MPT infants (290/7-336/7 weeks' gestational age), born between January 2012 and November 2013 and enrolled in the "MPT Registry" of the National Institute of Child Health and Human Development Neonatal Research Network.

RESULTS:

 Data were available for 5,886 infants, including 676 with no exposure, 1225 with partial, and 3,985 with a complete course of ANS. Among no, partial, and complete ANS groups, respectively, there were significant differences in rates of delivery room resuscitation (4.1, 1.4, and 1.2%), surfactant-treated respiratory disease (26.5, 26.3, and 20%), and severe intracranial hemorrhage (3, 2, and 0.8%). Complete ANS course was associated with lower surfactant-treated respiratory disease, compared with partial ANS (odds ratio [OR] 0.62; 95% confidence interval [CI] 0.52-0.74), and no ANS groups (OR 0.52; 95% CI 0.41-0.66) on adjusted analysis.

CONCLUSION:

 In MPT infants, ANS exposure is associated with lower delivery room resuscitation, surfactant-treated respiratory disease, and severe intracranial hemorrhage; with the lowest frequency of morbidities associated with a complete course.

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