title: Antenatal corticosteroids prior to 24 weeks' gestation and neonatal outcome of extremely low birth weight infants.
abstract: We sought to determine if antenatal corticosteroid treatment administered prior to 24 weeks' gestation influences neonatal morbidity and mortality in extremely low-birth-weight infants. A retrospective review was performed of all singleton pregnancies treated with one complete course of antenatal corticosteroids prior to 24 weeks' gestation and delivered between 23(0)/(7) and 25(6)/(7) weeks. These infants were compared with similar gestational-age controls. There were no differences in gender, race, birth weight, and gestational age between the groups. Infants exposed to antenatal corticosteroids had lower mortality (29.3% versus 62.9%, P = 0.001) and grade 3 or 4 intraventricular hemorrhage (IVH; 16.7% versus 36%, P < 0.05; relative risk [RR]: 2.16). Grade 3 and 4 IVH was associated with significantly lower survival probability as compared with no IVH or grade 1 and 2 IVH (P < 0.001, RR: 10.6, 95% confidence interval [CI]: 4.4 to 25.6). Antenatal steroid exposure was associated with a 62% decrease in the hazard rate compare with those who did not receive antenatal steroids after adjusting for IVH grade (Cox proportional hazard model, hazard ratio 0.38, 95% CI: 0.152 to 0.957, P = 0.04). The rates of premature rupture of membranes and chorioamnionitis were higher for infants exposed to antenatal corticosteroids. Exposure to a single course of antenatal corticosteroids prior to 24 weeks' gestation was associated with reduction of the risk of severe IVH and neonatal mortality for extremely low-birth-weight infants.
authors: Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Soraya.abbasi@uphs.upenn.edu
authors: Soraya
authors: S
authors: Abbasi
authors: Corrina
authors: C
authors: Oxford
authors: Jeffrey
authors: J
authors: Gerdes
authors: Harish
authors: H
authors: Sehdev
authors: Jack
authors: J
authors: Ludmir
mesh_terms: D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids