Partial or complete antenatal steroids treatment and neonatal outcome in extremely low birth weight infants < or =1000 g: is there a dose-dependent effect?
OBJECTIVE
To assess the outcome of extremely low birth weight (ELBW) infants < or =1000 g as it relates to antenatal steroids (ANS) therapy.


METHODS
A retrospective analysis of 124 infants born between January 1995 and December 1997. Infants born to mothers with pregnancy-induced hypertension, diabetes, and severe growth restriction were excluded. In all, 77 (62%) infants were exposed to ANS, of whom 31 (25%) received one to two doses (partial course), and 46 (37%) received three to four doses (complete course). A total of 47 infants (38%) were not exposed to ANS.


RESULTS
Infants not exposed to ANS, who exhibited more HMD, PDA, and IVH, were administered more surfactants, and were more likely to die versus infants with complete ANS dosing. Regression models revealed a dose-dependent effect of ANS on HMD, surfactant use, IVH, and CLD or death, with a significant decrease in HMD with > or =2 ANS doses.


CONCLUSIONS
ANS, in a dose-dependent way, are associated with improved outcome in ELBW infants < or =1000 g, with the best outcome seen after a complete course.
Salhab
Walid A
WA
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Hynan
Linda S
LS
Perlman
Jeffrey M
JM
D002908:Chronic Disease; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007969:Leukomalacia, Periventricular / Q000517:prevention & control; D016015:Logistic Models; D008171:Lung Diseases / Q000517:prevention & control; D008297:Male; D016017:Odds Ratio; D012044:Regression Analysis; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control; D012189:Retrospective Studies
D005938:Glucocorticoids; D003907:Dexamethasone