Antenatal glucocorticoid treatment decreases mortality and chronic lung disease in survivors among 23- to 28-week gestational age preterm infants.
The purpose of this study was to analyze the influence of antenatal glucocorticoid therapy (AGT) on mortality and chronic lung disease (CLD) in surviving preterm infants 23 to 28 weeks gestational age (WGA). This was a multicenter, prospective, observational study. A total of 2448 infants 23 to 28 WGA were born in 2002 to 2003; 27.7% did not receive AGT, 18.8% were exposed to partial AGT, and 53.5% were exposed to complete AGT. A total of 883 died and 22.9% of 1537 survivors were affected by CLD. Unadjusted univariate analysis showed AGT was associated with a reduction in mortality (p<0.001), either with partial or complete AGT courses, and also with a reduction in CLD in survivors (p<0.001), but only with complete AGT courses. In logistic regression analysis adjusted for confounding factors and a propensity score for AGT, AGT was significant and independently associated with a reduction of mortality, but only for complete AGT course (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.47 to 0.87; p=0.004), and with a decrease in CLD if a complete AGT course was administered (OR, 0.63; 95% CI, 0.45 to 0.89; p=0.009). A complete course of AGT in 23 to 28 WGA pregnancies is associated with decreased rates of neonatal mortality and CLD disease in surviving infants.
Figueras-Aloy
José
J
Hospital Clínic, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unidad Integrada de Pediatría, Universitat de Barcelona, Barcelona, Spain.
Serrano
Manuel Moro
MM
Rodríguez
Jesús Pérez
JP
Pérez
Cristina Fernández
CF
Serradilla
Vicente Roqués
VR
Jiménez
José Quero
JQ
González
Rafael Jiménez
RJ
D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy* / Q000401:mortality* / Q000517:prevention & control; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
D005938:Glucocorticoids