Impact of timing of antenatal corticosteroid exposure on neonatal outcomes.
OBJECTIVE
To evaluate morbidities among neonates with a history of remote antenatal corticosteroid (ACS) exposure compared to those with recent exposure.


METHODS
This is a retrospective-cohort study of neonates born at 30-33 6/7 weeks gestational age. The primary outcome was newborn respiratory distress syndrome (RDS) defined by the persistent need for oxygen at 24 h of life. Maternal chart review established timing of ACS exposure. Data were stratified by the time interval of ACS administration to delivery: none or <48 h (Incomplete/Unexposed), 48 h to 7 days (Recent) and >7 days (Remote). Perinatal outcomes were compared between groups.


RESULTS
Five hundred and twenty-four infants were included: 273 Incomplete/Unexposed, 120 Recent and 131 with Remote ACS exposure. RDS was significantly less frequent with Recent vs. Remote exposure (RR: 1.73 [1.01-3.02]p = 0.04). This finding persisted in a logistic regression model.


CONCLUSIONS
Infants delivering more than 1 week after ACS exposure have a higher frequency of RDS than those who deliver within 1 week.
Waters
Thaddeus P
TP
Department of Obstetrics and Gynecology, Suite G240, Metrohealth Medical Center, 2500 MetroHealth Dr, Cleveland, OH, USA.
Mercer
Brian
B
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*; D012189:Retrospective Studies; D013997:Time Factors
D000305:Adrenal Cortex Hormones