Antenatal steroids and intraventricular hemorrhage after premature rupture of membranes at 24-28 weeks' gestation.
To determine whether antenatal corticosteroid administration after midtrimester premature rupture of membranes (PROM) reduces the incidence or severity of neonatal intraventricular hemorrhage, we identified a cohort of infants delivered between 24 to 28 weeks gestation (n = 75) by mothers with PROM. Information was obtained from a computerized database (n = 3716) of all newborns admitted to the neonatal intensive care unit at a single medical center from 1991 to 1996. We reviewed records of each mother-infant pair to determine antenatal corticosteroid administration, presence, and severity of neonatal intraventricular hemorrhage, and frequency of infectious complications. Using a logistic regression model, antenatal corticosteroid administration was associated with a significantly reduced risk of severe (grade 3-4) intraventricular hemorrhage (0.1 odds ratio, 0.006-0.57, 95% confidence interval), but not a reduced incidence of intraventricular hemorrhage (grade 1-4, 0.4 odds ratio, 0.12-1.05, 95% confidence interval).
Chen
B
B
Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA.
Basil
J B
JB
Schefft
G L
GL
Cole
F S
FS
Sadovsky
Y
Y
D000328:Adult; D001424:Bacterial Infections / Q000517:prevention & control; D001623:Betamethasone / Q000627:therapeutic use*; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000517:prevention & control; D002821:Chorioamnionitis / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control; D015331:Cohort Studies; D016001:Confidence Intervals; D003907:Dexamethasone / Q000627:therapeutic use*; D004716:Endometritis / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000517:prevention & control*; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007256:Information Systems; D015931:Intensive Care, Neonatal; D016015:Logistic Models; D008297:Male; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D016017:Odds Ratio; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011645:Puerperal Infection / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors
D005938:Glucocorticoids; D003907:Dexamethasone; D001623:Betamethasone