title: Antenatal Betamethasone: A Prolonged Time Interval from Administration to Delivery Is Associated with an Increased Incidence of Severe Intraventricular Hemorrhage in Infants Born before 28 Weeks Gestation.
abstract: To examine the effects of antenatal steroids on severe intraventricular hemorrhage (IVH) in infants born during the IVH vulnerable period (<28 weeks gestational age) and to evaluate rates of IVH correlated with the time interval between treatment or retreatment and birth.
  
  
  
  A total of 429 infants (<28 weeks gestation), who delivered ≥24 hours after the first betamethasone (BMZ) course (2 doses), were divided into groups based on the interval between the first course of BMZ and delivery: <10 days or ≥10 days. The primary outcome was severe IVH. Multiple regression analyses were performed to adjust for potential confounders.
  
  
  
  Three hundred ninety-two infants delivered after a single BMZ course (312 delivered <10 days; 80 ≥10 days). The incidence of severe IVH was 17% for infants delivered ≥10 days and 7% for those delivered <10 days after a single BMZ course (aOR 4.16; 95% CI 1.59-10.87, P = .004); 37 infants (born ≥10 days from the first BMZ course) received a second/rescue BMZ course. The incidence of severe IVH among infants receiving a second/rescue course was 8%, which was similar to the incidence among infants born <10 days (aOR 1.7; 95% CI 0.41-6.6, P = .48).
  
  
  
  In infants born before 28 weeks gestation, delivery ≥10 days from the first BMZ course is associated with a higher incidence of severe IVH; a second/rescue course may reverse this effect.
authors: Department of Pediatrics, University of California, San Francisco, San Francisco, CA.
authors: Melissa
authors: M
authors: Liebowitz
authors: Cardiovascular Research Institute and Department of Pediatrics, University of California San Francisco, San Francisco, CA. Electronic address: clymanr@peds.ucsf.edu.
authors: Ronald I
authors: RI
authors: Clyman
mesh_terms: D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D011295:Prenatal Care; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D005938:Glucocorticoids; D001623:Betamethasone
keywords: corticosteroids; intracranial hemorrhage; newborn; premature birth