The effects of multiple courses of antenatal corticosteroid therapy on perinatal outcomes in premature neonates

Choi, Suk Joo; Yang, Soon Ha; Choi, Seong Jin; Seo, Yong Soo; Kim, Young Ah; Roh, Cheong Rae; Kim, Jong Hwa

Abstract

OBJECTIVE
The aims of this study are to determine the effects of multiple courses of antenatal corticosteroid therapy on the perinatal outcomes, especially the respiratory outcomes of the preterm neonates and to compare them with the single course of antenatal corticosteroid therapy.
METHODS
We performed a retrospective analysis of 282 mothers who admitted between 24 and 34 weeks' gestation with high risk of preterm delivery and delivered before 34 weeks' gestation. They were categorized into three groups; (1) no antenatal corticosteroid user (non-user group), (2) single course of corticosteroid user (single-course group), (3) multiple courses of corticosteroid user (multiple-course group). Then we compared the pregnancy results and the perinatal outcomes, especially the respiratory outcomes of neonates in each groups.
RESULTS
One hundred twenty-four patients were included in steroid non-user group, 111 patients in single- course group and 47 patients in multiple-course group respectively. There were no statistical differences of pregnancy results including the occurrence of clinical and histological chorioamnionitis, gestational age at delivery, birth weight, neonatal intensive care unit admission rate and hospital stay, ventilator treatment rate and neonatal death among the three groups. But the duration of ventilator treatment was significantly shorter in multiple-course group. The incidence of neonatal respiratory distress syndrome was significantly lower in multiple-course group, and the incidence tends to decrease as the number of corticosteroid use increases. Multiple logistic regression analysis and Spearman's partial correlation test revealed that multiple courses of antenatal corticosteroid treatment were significantly associated with lower incidence of neonatal respiratory distress syndrome and shorter duration of ventilator treatment respectively, even after the adjustment of other independent variables. There were no significant differences of other neonatal morbidities among the three groups.
CONCLUSION
Multiple doses of antenatal corticosteroid administered to patients with risk of preterm delivery is associated with shorter duration of ventilator therapy and lower incidence of respiratory distress syndrome of the premature neonates without complicating any other perinatal outcomes.