title: Effect of antenatal corticosteroids on respiratory morbidity in singletons after late-preterm birth.
abstract: OBJECTIVE
  To evaluate whether neonates born to women who previously had received antenatal corticosteroids and then delivered a late-preterm-birth neonate had less respiratory morbidity compared with those not exposed to antenatal corticosteroids.
  
  
  METHODS
  This is a secondary analysis from a multicenter observational study regarding mode of delivery after previous cesarean delivery. We compared women who received one course of antenatal corticosteroids with unexposed parturients and evaluated various respiratory outcomes among those having a singleton, late-preterm-birth neonate. We controlled for potential confounders including gestational age at delivery, diabetes, mode of delivery, and maternal race.
  
  
  RESULTS
  Five thousand nine hundred twenty-four patients met the inclusion criteria; 550 received steroids and 5,374 did not. In the univariable model, compared with unexposed women, those who received antenatal corticosteroids appeared more likely to have neonates who required ventilatory support (11.5% compared with 8.6%, P=.022), had respiratory distress syndrome (RDS) (17.1% compared with 12.2%, P=.001), developed transient tachypnea of the newborn (12.9% compared with 9.8%, P=.020), or required resuscitation in the delivery room (55.8% compared with 49.7%, P=.007). After controlling for confounding factors, we found no significant differences among the groups regarding all of the above outcomes with an odds ratio for RDS of 0.78 (95% confidence interval, 0.60-1.02) and ventilator support of 0.75 (95% confidence interval, 0.55-1.03).
  
  
  CONCLUSIONS
  Exposure to antenatal corticosteroids does not significantly affect respiratory outcomes among those with a subsequent late-preterm birth.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University, New York, New York 10032, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gyamfi-Bannerman
authors.forename: Sharon
authors.initials: S
authors.lastname: Gilbert
authors.forename: Mark B
authors.initials: MB
authors.lastname: Landon
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Meis
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Marshall
authors.initials: M
authors.lastname: Carpenter
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.forename: Mary J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: Baha M
authors.initials: BM
authors.lastname: Sibai
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009017:Morbidity; D015337:Multicenter Studies as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced* / Q000503:physiopathology; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000139:chemically induced*; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000139:chemically induced* / Q000628:therapy
chemical_list: D000305:Adrenal Cortex Hormones