Antenatal Corticosteroids Prior to 24 Weeks' Gestation and Neonatal Outcome of Extremely Low Birth Weight Infants

Soraya Abbasi; Corrina Oxford; Jeffrey Gerdes; Harish Sehdev; Jack Ludmir

doi:10.1055/s-0029-1223269

American Journal of Perinatology, Table of Contents

Am J Perinatol 2010; 27(1): 061-066
DOI: 10.1055/s-0029-1223269

Antenatal Corticosteroids Prior to 24 Weeks' Gestation and Neonatal Outcome of Extremely Low Birth Weight Infants

Soraya Abbasi¹ , Corrina Oxford² , Jeffrey Gerdes¹ , Harish Sehdev² , Jack Ludmir²

¹Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania
²Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania

Abstract

ABSTRACT

We sought to determine if antenatal corticosteroid treatment administered prior to 24 weeks' gestation influences neonatal morbidity and mortality in extremely low-birth-weight infants. A retrospective review was performed of all singleton pregnancies treated with one complete course of antenatal corticosteroids prior to 24 weeks' gestation and delivered between 23⁰/₇ and 25⁶/₇ weeks. These infants were compared with similar gestational-age controls. There were no differences in gender, race, birth weight, and gestational age between the groups. Infants exposed to antenatal corticosteroids had lower mortality (29.3% versus 62.9%, p = 0.001) and grade 3 or 4 intraventricular hemorrhage (IVH; 16.7% versus 36%, p < 0.05; relative risk [RR]: 2.16). Grade 3 and 4 IVH was associated with significantly lower survival probability as compared with no IVH or grade 1 and 2 IVH (p < 0.001, RR: 10.6, 95% confidence interval [CI]: 4.4 to 25.6). Antenatal steroid exposure was associated with a 62% decrease in the hazard rate compare with those who did not receive antenatal steroids after adjusting for IVH grade (Cox proportional hazard model, hazard ratio 0.38, 95% CI: 0.152 to 0.957, p = 0.04). The rates of premature rupture of membranes and chorioamnionitis were higher for infants exposed to antenatal corticosteroids. Exposure to a single course of antenatal corticosteroids prior to 24 weeks' gestation was associated with reduction of the risk of severe IVH and neonatal mortality for extremely low-birth-weight infants.

KEYWORDS

Antenatal steroids - extremely low-birth-weight infants - neonatal outcomes

Full Text

References

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Soraya AbbasiM.D.

CHOP Newborn Care, Pennsylvania Hospital, 800 Spruce Street

Philadelphia, PA 19107

Email: Soraya.abbasi@uphs.upenn.edu