Antenatal steroids, condition at birth and respiratory morbidity and mortality in very preterm infants.
OBJECTIVE
To investigate (1) perinatal factors affecting condition at birth in very preterm infants (23-32 weeks) and (2) the relationship between poor condition at birth and neonatal respiratory morbidity and mortality.


METHODS
Convenience sample (n = 479) drawn from a geographic population inception cohort.


RESULTS
Antenatal steroid use reduced the risk of pH < or = 7.20 [Adjusted Odds Ratio 0.29 (95% CI 0.17, 0.50)], one minute Apgar < 4 [0.54 (0.33, 0.88)], and 5 min Apgar < 7 [0.44 (0.23, 0.84)]. Gestational age was significantly related to Apgar score but not cord arterial acid-base status. No other perinatal factor was significant. Poor condition at birth was associated with an increase in the incidence and severity of hyaline membrane disease and death. These effects were lessened in those exposed to steroids.


CONCLUSIONS
Antenatal steroid use is associated with improved condition at birth and reduces the deleterious effects of poor condition at birth on early respiratory morbidity and mortality.
Ee
L
L
Department of Neonatal Paediatrics, University of Western Australia, King Edward Memorial Hospital for Women, Perth, Western Australia.
Hagan
R
R
Evans
S
S
French
N
N
D000136:Acid-Base Equilibrium; D001034:Apgar Score; D001784:Blood Gas Analysis; D015331:Cohort Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005865:Gestational Age; D006304:Health Status; D006801:Humans; D006819:Hyaline Membrane Disease / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology; D011295:Prenatal Care / Q000379:methods; D011297:Prenatal Exposure Delayed Effects; D012120:Respiration Disorders / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013256:Steroids / Q000627:therapeutic use*; D014904:Western Australia / Q000453:epidemiology
D013256:Steroids