Repeated antenatal corticosteroid treatments. Do they reduce neonatal morbidity?
OBJECTIVE
To compare the effectiveness of single, as compared to multiple, courses of antenatal steroid treatments in reducing neonatal morbidity.


METHODS
A retrospective chart review of 204 patients who delivered preterm and received antenatal corticosteroids between June 1996 and December 1998 was performed and data extracted. All patients who delivered prior to 35 weeks of gestation and received corticosteroids were included. The number of antenatal treatments was chosen by the obstetrician caring for the patient as well as by the opportunity to administer steroids.


RESULTS
There were 61 patients in the multiple-course group. Gestational age was greater in the multiple-course group (31.6 vs. 30.6, P = 0.3), but Apgar scores, neonatal hospital stay, specific neonatal morbidity and combined morbidity were not different between the two groups. Combined neonatal morbidity was higher after three courses of antenatal steroids (29% vs. 50%). Logistic regression analyses adjusting for gestational age suggest a possible adverse effect of multiple courses, development of respiratory distress syndrome (odds ratio 1.3; confidence interval 1.02; 1.8; P = .02) and combined neonatal morbidity (odds ratio 1.3; confidence interval 1.04; 1.7; P = .02).


CONCLUSIONS
Weekly antenatal steroids do not improve neonatal morbidity.
Jazayeri
A
A
Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA. obgaj@ttuhsc.edu
Gavrila
D
D
Sincich
T
T
D000328:Adult; D001034:Apgar Score; D001623:Betamethasone / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D005325:Fetal Organ Maturity; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007273:Injections, Intramuscular; D007902:Length of Stay; D008145:Louisiana / Q000453:epidemiology; D008168:Lung / Q000196:embryology*; D008297:Male; D008499:Medical Records; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology* / Q000517:prevention & control*; D012189:Retrospective Studies
D005938:Glucocorticoids; D003907:Dexamethasone; D001623:Betamethasone