title: Association of antenatal corticosteroids and the mode of delivery with the mortality and morbidity of infants weighing less than 1,500g at birth in Japan.
abstract: OBJECTIVE
  This study aimed to re-evaluate the effectiveness of antenatal corticosteroids (ACS) and to analyze the association between ACS and the mode of delivery in the context of perinatal morbidity and mortality in very-low-birth-weight (VLBW) infants.
  
  
  METHODS
  This retrospective cohort study involved 15,765 VLBW infants born between 2003 and 2008 at less than 34 weeks of gestation and weighing less than 1,500 g at birth. Data were obtained from the Japanese neonatal research network database. Univariate and multivariate logistic regression analyses were performed to evaluate the impact of ACS and mode of delivery on the risk of infant mortality and morbidity.
  
  
  RESULTS
  Administration of ACS was associated with decreases in mortality rate, intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP), and was not associated with the incidence of respiratory distress syndrome (RDS), periventricular leukomalacia or necrotizing enterocolitis (NEC). When the administration of ACS was analyzed in the context of different modes of delivery, the incidence of IVH and ROP tended to decrease with cesarean section deliveries, whereas the incidence of RDS tended to decrease and the incidence of NEC tended to increase for infants delivered vaginally. The incidence of chronic lung disease tended to increase in association with both delivery methods.
  
  
  CONCLUSIONS
  This large cohort study reconfirms that ACS treatment is associated with decreases in infant mortality and severe morbidity. Furthermore, the delivery method may be associated with severe morbidity in VLBW infants exposed to ACS.
authors.affiliation: Department of Neonatology, Otsu Red Cross Hospital, Otsu, Japan.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Nishimura
authors.forename: Shinji
authors.initials: S
authors.lastname: Katsuragi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Sengoku
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kusuda
authors.forename: Masanori
authors.initials: M
authors.lastname: Fujimura
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D016208:Databases, Factual; D036861:Delivery, Obstetric / Q000379:methods*; D004334:Drug Administration Schedule; D020345:Enterocolitis, Necrotizing / Q000401:mortality / Q000517:prevention & control; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D020300:Intracranial Hemorrhages / Q000401:mortality / Q000517:prevention & control; D007564:Japan / Q000453:epidemiology; D007969:Leukomalacia, Periventricular / Q000401:mortality / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000517:prevention & control; D012178:Retinopathy of Prematurity / Q000401:mortality / Q000517:prevention & control; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D000305:Adrenal Cortex Hormones