title: Association Between Antenatal Corticosteroid Administration-to-Birth Interval and Outcomes of Preterm Neonates.
abstract: OBJECTIVE
  To assess the association between antenatal corticosteroid administration-to-birth interval and outcomes.
  
  
  METHODS
  In this retrospective cohort study, data on singleton neonates born between 24 0/7 and 33 6/7 weeks of gestation and admitted to tertiary neonatal units in Canada during 2010-2012 were obtained from the Canadian Neonatal Network. Neonatal outcomes were compared among four groups based on the interval between antenatal corticosteroid administration and birth: no antenatal corticosteroids, partial antenatal corticosteroids (less than 24 hours before birth), antenatal corticosteroids 1-7 days before birth, and antenatal corticosteroids greater than 7 days before birth. Composite outcome was defined as any of neonatal mortality, bronchopulmonary dysplasia, grade 3-4 intraventricular hemorrhage, periventricular leukomalacia, or stage 3 or higher retinopathy.
  
  
  RESULTS
  Of 6,870 eligible neonates, 1,378 (20%) received no antenatal corticosteroids; 1,473 (21%) received partial antenatal corticosteroids; 2,721 (40%) received antenatal corticosteroids 1-7 days before birth; and 1,298 (19%) received antenatal corticosteroids greater than 7 days before birth. The odds of the composite adverse outcome were significantly higher in all groups compared with neonates who received antenatal corticosteroids 1-7 days before birth (no antenatal corticosteroids: adjusted odds ratio [OR] 2.12, 95% confidence interval [CI] 1.69-2.65; partial antenatal corticosteroids: adjusted OR 1.48, 95% CI 1.22-1.80; and antenatal corticosteroids at greater than 7 days: adjusted OR 1.46, 95% CI 1.20-1.77). Similar findings were observed with respect to neonatal mortality (no antenatal corticosteroids: adjusted OR 2.56, 95% CI 1.83-3.59; partial antenatal corticosteroids: adjusted OR 1.59, 95% CI 1.16-2.18; and antenatal corticosteroids at greater than 7 days: adjusted OR 1.40, 95% CI 1.00-1.97).
  
  
  CONCLUSIONS
  Antenatal corticosteroids had maximum benefit when given between 1 and 7 days before birth.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Center, the Departments of Obstetrics and Gynecology and Paediatrics, University of Toronto, and the Departments of Pediatrics and Obstetrics and Gynecology and the Maternal-Infant Research Centre (MiCare), Mount Sinai Hospital, Toronto, Ontario, and the Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Nir
authors.initials: N
authors.lastname: Melamed
authors.forename: Jyotsna
authors.initials: J
authors.lastname: Shah
authors.forename: Amuchou
authors.initials: A
authors.lastname: Soraisham
authors.forename: Eugene W
authors.initials: EW
authors.lastname: Yoon
authors.forename: Shoo K
authors.initials: SK
authors.lastname: Lee
authors.forename: Prakesh S
authors.initials: PS
authors.lastname: Shah
authors.forename: Kellie E
authors.initials: KE
authors.lastname: Murphy
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology* / Q000517:prevention & control; D002170:Canada / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000517:prevention & control; D002552:Cerebral Ventricles; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D011247:Pregnancy; D047928:Premature Birth / Q000188:drug therapy; D011295:Prenatal Care; D012178:Retinopathy of Prematurity / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones