title: Antenatal steroid use is associated with increased gastroesophageal reflux in neonates.
abstract: The objective of this study was to analyze if repetitive administration of antenatal steroids (ANS) had an adverse impact on neonatal outcome at hospital discharge in premature infants. We used a retrospective analysis of 306 infants of gestational age (GA) < or = 34 weeks born between January 1997 and June 1999. A detailed review of maternal and neonatal charts was done. Seventy-one percent (216/306) received ANS. While there was no difference in birth weight (1.37 +/- 0.04 versus 1.49 +/- 0.06 kg; p = 0.09), infants receiving ANS were of lesser GA (29.5 +/- 0.2 versus 30.5 +/- 0.4 weeks; p = 0.02). More babies who received ANS had clinical evidence of gastroesophageal reflux (GER) [59/216 (27%) versus 11/90 (12%); p = 0.007]. After correcting for GA, infants receiving ANS were less likely to need surfactant (p = 0.03) and more likely to be diagnosed with clinical GER (p = 0.02). Ninety (29%) infants received no ANS, 47 (15%) received a suboptimal course, 112 (37%) infants received 1 course of ANS, and 57 (19%) infants received > or = 2 courses. There was a significant increase in the incidence of GER with increasing courses of ANS: 0 course 11/90 (12%), suboptimal 12/47 (26%), 1 course 28/112 (25%), 2 or more courses 18/57 (32%); p = 0.006, linear trend. The increased incidence of GER (p = 0.01) still held true among infants who had GER confirmed by a pH-probe study. Use of ANS is associated with a significantly decreased need for surfactant; however, there is an increased incidence of GER.
authors.affiliation: Department of Pediatrics, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Song-Ok S
authors.initials: SO
authors.lastname: Chin
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Brodsky
authors.forename: Vineet
authors.initials: V
authors.lastname: Bhandari
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001623:Betamethasone / Q000009:adverse effects*; D003907:Dexamethasone / Q000009:adverse effects*; D005260:Female; D005764:Gastroesophageal Reflux / Q000139:chemically induced*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000139:chemically induced*; D016015:Logistic Models; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D001623:Betamethasone