The effect of time interval between a single course of antenatal corticosteroids and delivery on outcomes in preterm neonates

Kang, Yun Dan; Park, Man Chul

Abstract

OBJECTIVE
To determine whether the beneficial effects of a single course of antenatal corticosteroids for neonatal morbidity change with time
METHODS
A retrospective chart review was performed of women who received a single complete course of antenatal corticosteroid and delivered a viable singleton infant between 26 and 35 weeks of gestation. Patients were divided into 1 of 3 groups on the basis of the interval from first corticosteroid dose to delivery (48 hr~7 days, 8~14 days and > or =15 days). Neonatal morbidities were compared between each groups.
RESULTS
Two hundred three pregnancies were included, of which 78 women delivered at 48 hr-7 days, 65 women delivered at 8~14 days and 60 women delivered at > or =15 days. The 3 groups were similar in clinical characteristics and indications for antenatal steroids and delivery. Neonates delivered within 7 days had a lower incidence of receiving ventilatory support for more than 24 hours than 8~14 days group (32.1% vs 50.8%, P=0.023) and > or =15 days group (32.1% vs 51.7%, P=0.02). But there were no significant differences between the groups in ventilator days, surfactant use, oxygen dependency at 36 weeks of gestation, oxygen dependency at 28 days after delivery, intraventricular hemorrhage, necrotizing enterocolitis, sepsis and length of hospital days. There were no periventricular leukomalacia and neonatal death in all groups.
CONCLUSION
Neonates delivered more than 7 days after first corticosteroid dose needed more short-term ventilatory support, but there were no differences in other neonatal outcomes.