title: Neurodevelopmental outcome of extremely premature infants exposed to incomplete, no or complete antenatal steroids.
abstract: OBJECTIVE
  To compare the neurodevelopmental outcomes at 18-22 months' corrected age of extremely premature infants exposed to a complete course, an incomplete course or no dose of antenatal steroids (ANS).
  
  
  METHODS
  Retrospective chart review of extremely premature (<28 weeks gestational age) neonates over a 3-year period. Neurodevelopmental assessment at 18-22 months' corrected age included a standardized neurologic examination and the Bayley Scales of Infant and Toddler development II or III. Intact survival was defined as survival without cerebral palsy (CP), blindness or deafness and mental developmental index (MDI)/cognitive score ≥85. Neurodevelopmental impairment (NDI) was defined as any of the following: moderate or severe CP, MDI/cognitive score <70, deafness or blindness. Patients were categorized into three groups: (A) no ANS; (B) incomplete course and (C) complete course of ANS.
  
  
  RESULTS
  Outcome data were available for 134 (88%) patients of our cohort (n = 153). Severe intraventricular hemorrhage (IVH) was significantly lower and intact survival was higher in the complete ANS group (p < 0.01). On logistic regression, with gestational age, gender, maternal insurance and ANS exposure as covariates, an incomplete (versus complete) course of ANS (p = 0.006) and gestational age were significantly associated with lower intact survival at 18-22 months.:
  
  
  CONCLUSIONS
  A complete course of ANS was associated with an increased likelihood of intact survival at a corrected age of 18-22 months among extremely premature infants, compared with an incomplete course. Follow-up studies should account for the differential benefit of complete versus incomplete course of ANS administration.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Children's Hospital of Michigan , Detroit, MI , USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Chawla
authors.forename: Roopali
authors.initials: R
authors.lastname: Bapat
authors.forename: Athina
authors.initials: A
authors.lastname: Pappas
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bara
authors.forename: Marwan
authors.initials: M
authors.lastname: Zidan
authors.forename: Girija
authors.initials: G
authors.lastname: Natarajan
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D001766:Blindness / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D002547:Cerebral Palsy / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology; D003638:Deafness / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D062071:Infant, Extremely Premature / Q000502:physiology*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D009420:Nervous System / Q000254:growth & development*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care
chemical_list: D000305:Adrenal Cortex Hormones