title: Do prenatal steroids improve the survival of late preterm infants with complex congenital heart defects?
abstract: OBJECTIVE
  We evaluated the use of prenatal steroids (PNS) and the effect of that practice on hospital mortality of late preterm infants with complex congenital heart defects (CHD).
  
  
  METHODS
  Retrospective review of records of late preterm infants with complex CHD infants that were cared for in a single tertiary perinatal center between 2002 and 2009. Multivariate logistic regression analysis was performed to determine which of the risk factors commonly associated with death prior to discharge from the hospital predict the outcome (hospital death).
  
  
  RESULTS
  Of the 106 late preterm infants with complex CHD, 31(29%) died and 15 (14%) received PNS. Endotracheal intubation in the delivery room (42% vs 15%), necrotizing enterocolitis (10% vs 0%) and hypoplastic left heart syndrome (52% vs 25%) were statistically more frequent in non-surviving infants. Non-surviving infants were more frequently treated with PNS (23% vs 11%) but this difference was not statistically significant (p = 0.131). Using logistic regression analysis, delivery room intubation (OR 4.91; 95% CI 1.78 - 13.51) and the hypoplastic left heart syndrome (OR 3.29; 95% CI 1.28 - 8.48), but not prenatal steroids were independently associated with increased risk of hospital death.
  
  
  CONCLUSIONS
  In a selected population of late preterm infants with complex CHD, prenatal steroid treatment did not independently influence survival.
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Attar
authors.affiliation: Department of Critical Care Support Services, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Dechert
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Schumacher
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: S
authors.initials: S
authors.lastname: Sarkar
mesh_terms: D005260:Female; D047109:Fetal Development / Q000187:drug effects*; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D017052:Hospital Mortality; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D008297:Male; D008431:Maternal-Fetal Exchange / Q000187:drug effects*; D011247:Pregnancy; D011295:Prenatal Care; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013256:Steroids / Q000008:administration & dosage*
chemical_list: D013256:Steroids
keywords: Late preterm infant; congenital heart defect; counseling; mortality; prenatal steroid