Multiple courses of antenatal corticosteroid therapy in patients with preterm premature rupture of membranes.
OBJECTIVE
This study was performed to determine the benefits and risks of multiple courses of corticosteroids in patients with preterm premature rupture of membranes (PPROM).


METHODS
We retrospectively evaluated the pregnancy and neonatal outcomes of women with singleton pregnancies, who were admitted at 24-32 weeks of gestation due to PPROM. Patients were categorized into 3 groups according to antenatal corticosteoid exposure: (1) a non-user group, (2) a single-course group, and (3) a multiple-course group.


RESULTS
A total of 170 patients were included in the study, with 50 in the non-use group, 76 in the single-course group, and 44 in the multiple-course group. Univariate analyses showed that clinical chorioamnionitis occurred with highest incidence in multiple-course group (chi2=6.20, p<0.05) and the incidence of neonatal respiratory distress syndrome (RDS) was lowest in the multiple-course group (chi2=10.0, p<0.01). Multiple logistic regression analyses showed that multiple courses of corticosteroids were independently associated with clinical chorioamnionitis (odds ratio=13.15, p<0.05) whereas no significant association was found between RDS and multiple-course corticosteroids after adjusting for confounding variables (odds ratio=0.28, p=0.06).


CONCLUSIONS
Multiple courses of antenatal corticosteroid therapy were found to be associated with an increased risk of clinical chorioamnionitis and seemed not to reduce the incidence of RDS and other neonatal morbidities in patients with PPROM.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. shyang@smc.samsung.co.kr
Soon Ha
SH
Yang
Suk Joo
SJ
Choi
Cheong Rae
CR
Roh
Jong Hwa
JH
Kim
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000704:Analysis of Variance; D002821:Chorioamnionitis / Q000453:epidemiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
D000305:Adrenal Cortex Hormones