Gestational age at glucocorticoids administration after premature rupture of membranes and cerebral white matter damage.
OBJECTIVE
We investigated whether gestational age at glucocorticoids administration in very preterm premature rupture of membranes (PROM) affects the occurrence of neonatal cerebral white matter damage (WMD).


METHODS
In a cohort of singleton neonates born at 24.0-33.6 weeks after PROM who underwent at least one full course of glucocorticoids (n = 130), we compared the gestational age at first and last course of glucocorticoids between those who developed WMD (n = 8) and those who did not (n = 122) after adjusting for gestational age at PROM using logistic regression with P < 0.05 considered significant.


RESULTS
Gestational age at first course of glucocorticoids (P = 0.2), at last course of glucocorticoids (P = 0.2) and at delivery (P = 0.2), were not significantly different between those who developed WMD and those who did not. Although latency between PROM and first course of glucocorticoids was protective against WMD (P = 0.02), the significance was lost after controlling for gestational age at PROM, which was significantly lower in cases that developed WMD (P < 0.01).


CONCLUSIONS
In very preterm PROM, the beneficial effect of glucocorticoids on occurrence of WMD is not related to gestational age at steroid administration.
Locatelli
Anna
A
Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano- Bicocca, Monza, Italy.
Ghidini
Alessandro
A
Incerti
Maddalena
M
Toso
Laura
L
Plevani
Cristina
C
Andreani
Marianna
M
Paterlini
Giuseppe
G
D000328:Adult; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D001930:Brain Injuries / Q000151:congenital* / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy* / Q000453:epidemiology; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology; D007234:Infant, Premature / Q000502:physiology; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors
D005938:Glucocorticoids