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

Sanjay Chawla; Girija Natarajan; Dhuly Chowdhury; Abhik Das; Michele Walsh; Edward F. Bell; Abbot R. Laptook; Krisa Van Meurs; Carl T. D'Angio; Barbara J. Stoll; Sara B. DeMauro; Seetha Shankaran

doi:10.1055/s-0038-1642059

American Journal of Perinatology, Table of Contents

Am J Perinatol 2018; 35(12): 1213-1221
DOI: 10.1055/s-0038-1642059

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Sanjay Chawla

¹Department of Pediatrics, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan

,

Girija Natarajan

¹Department of Pediatrics, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan

,

Dhuly Chowdhury

²Biostatistics and Epidemiology Division, RTI International, Rockville, Maryland

,

Abhik Das

²Biostatistics and Epidemiology Division, RTI International, Rockville, Maryland

,

Michele Walsh

³Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio

,

Edward F. Bell

⁴Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa

,

Abbot R. Laptook

⁵Department of Pediatrics, Women and Infants' Hospital of Rhode Island, Providence, Rhode Island

,

Krisa Van Meurs

⁶Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, California

,

Carl T. D'Angio

⁷Department of Pediatrics, University of Rochester, Rochester, New York

,

Barbara J. Stoll

⁸McGovern Medical School at the University of Texas Health Science Center, Houston, Texas

,

Sara B. DeMauro

⁹Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Seetha Shankaran

¹Department of Pediatrics, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan

› Author Affiliations

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 (29^0/7–33^6/7 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.

Keywords

antenatal steroids - surfactant - gestational age - intracranial hemorrhage - necrotizing enterocolitis

Full Text

References

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