Korean J Obstet Gynecol.  2004 Feb;47(2):250-257.

The Benefits and Risks of Multiple Courses of Antenatal Corticosteroid Therapy in Patients with Preterm Premature Rupture of Membranes

• Yang SH
• Choi SR
• Choi SJ
• Lee JS
• Seo YS
• Kim JH

Abstract

OBJECTIVE
This study was performed to determine the benefits and risks of multiple courses of corticosteroids in patients with preterm premature rupture of membranes (PPROM).
METHODS
We retrospectively evaluated the pregnancy and neonatal outcomes for women of singleton pregnancy with PPROM admitted at 24-32 weeks of gestation. Patients were categorized into 3 groups according to antenatal corticosteroids exposure: (1) non-user group, (2) single-course group, (3) multiple-course group. Chi-square test, analysis of variances, Kruskal-Wallis test, and multiple logistic regression analysis were used for statistical analyses.
RESULTS
A total of 170 patients were included, with 50 in non-use group, 76 in single-course group, and 44 in multiple-course group. Univariate analyses showed that clinical chorioamnionitis occurred in the highest incidence in multiple-course group (x2=6.20, p<0.05) and the decreased incidence of RDS in multiple-course group (x2=10.0, p<0.01). Multiple logistic regression analyses demonstrated that no significant association was found after adjustment of confounding variables (odds ratio=0.28, p=0.063) whereas multiple courses of corticosteroids were independently associated with clinical chorioamnionitis (odds ratio=13.15, p=0.025).
CONCLUSION
Multiple courses of antenatal corticosteroids therapy did not reduce the incidence of RDS in neonates and were associated with increased risk of clinical chorioamnionitis in patients with PPROM.

Keyword

Antenatal corticosteroids therapy; Multiple courses; Preterm premature rupture of membranes; Repiratory distress syndrome; Clinical chorioamnionitis

MeSH Terms

Adrenal Cortex Hormones
Chorioamnionitis
Confounding Factors (Epidemiology)
Female
Humans
Incidence
Infant, Newborn
Logistic Models
Membranes*
Pregnancy
Retrospective Studies
Risk Assessment*
Rupture*
Adrenal Cortex Hormones