The association of antenatal corticosteroids with neonatal hypoglycemia and hyperbilirubinemia.
OBJECTIVE
While antenatal corticosteroids reduce the risk of neonatal morbidity and mortality, perhaps the maternal hyperglycemia they produce has other neonatal effects. Thus, we sought to examine the association between antenatal betamethasone exposure and neonatal hypoglycemia and hyperbilirubinemia.


METHODS
We designed a retrospective cohort study of all preterm deliveries from 32 to 37 weeks of gestation at a single university hospital from 1990 to 2007. Data were collected on antenatal betamethasone administration and the neonatal outcomes. Univariable, multivariable and stratified analyses were conducted.


RESULTS
Of 6675 preterm deliveries, significantly higher rates of neonatal hypoglycemia (5.7% versus 4.2%, p<0.05) and hyperbilirubinemia (45.9% versus 24.1%, p<0.05) were observed in neonates exposed to antenatal betamethasone. Controlling for potential confounders including gestational age, these findings persisted with betamethasone-exposed neonates 1.6 times more likely to have hypoglycemia (aOR 1.60, 95% CI 1.24-2.07) and 3.2 times more likely to have hyperbilirubinemia (aOR 3.23, 95% CI 2.92-3.58).


CONCLUSIONS
Antenatal betamethasone was associated with neonatal hypoglycemia and hyperbilirubinemia. Further work to determine whether this association is related to maternal hyperglycemia should be conducted, given this could be addressed with strict maternal glycemic control during betamethasone administration.
Department of Reproductive Medicine, San Diego Health System, University of California , San Diego, CA , USA .
Kate E
KE
Pettit
Susan H
SH
Tran
Erin
E
Lee
Aaron B
AB
Caughey
D000328:Adult; D001623:Betamethasone / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000139:chemically induced*; D007003:Hypoglycemia / Q000139:chemically induced*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000139:chemically induced*; D015999:Multivariate Analysis; D011247:Pregnancy; D012189:Retrospective Studies
D005938:Glucocorticoids; D001623:Betamethasone