Antenatal corticosteroids and cranial ultrasonographic abnormalities.
OBJECTIVE
This study was undertaken to determine whether very-low-birth-weight infants whose mothers received a course of antenatal corticosteroids were at decreased risk for 3 cranial ultrasonographic entities that predict neurodevelopmental dysfunction.


METHODS
This retrospective cohort study evaluated 1604 infants weighing 500 to 1500 g who underwent >/=1 of 3 cranial ultrasonographic scans required by design at specified postnatal intervals and whose own and mother's hospital charts were reviewed. Infants were classified according to mother's course of antenatal corticosteroids (none, partial, or complete).


RESULTS
In the total sample the risks of intraventricular hemorrhage and of an echolucent image in the cerebral white matter were only modestly (and not statistically significantly) reduced after a full course of antenatal corticosteroids, whereas antenatal corticosteroids appeared to significantly reduce the risk of ventriculomegaly after even a partial course. Antenatal corticosteroids appeared to halve the risk of ventriculomegaly and echolucent image among the gestationally youngest infants and those with intraventricular hemorrhage, hypothyroxinemia, or vasculitis of the umbilical cord or chorionic plate of the placenta.


CONCLUSIONS
These observations are consistent with the hypothesis that antenatal corticosteroids protect very-low-birth-weight infants, especially those who are most vulnerable, against the risk of cranial ultrasonographic abnormalities.
Leviton
A
A
Children's Hospital, Harvard Medical School, Harvard School of Public Health, Boston, Massachusetts, USA.
Dammann
O
O
Allred
E N
EN
Kuban
K
K
Pagano
M
M
Van Marter
L
L
Paneth
N
N
Reuss
M L
ML
Susser
M
M
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D001921:Brain / Q000002:abnormalities; D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000517:prevention & control; D002552:Cerebral Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging; D015331:Cohort Studies; D004453:Echoencephalography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D015999:Multivariate Analysis; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors
D000305:Adrenal Cortex Hormones