Perinatology.  2018 Sep;29(3):101-106. 10.14734/PN.2018.29.3.101.

The Effects of Incomplete Antenatal Corticosteroid Therapy Prior to Delivery on Clinical Outcomes of Preterm Infants

• Park SK
• Kim DH
• Kim HS

• KMID: 2421574
• DOI: http://doi.org/10.14734/PN.2018.29.3.101

Abstract

OBJECTIVE
To investigate the effect of incomplete antenatal corticosteroid therapy (ACST) prior to delivery on clinical outcomes of preterm infants.
METHODS
Preterm infants born between 24 0/7 and 33 6/7 weeks of gestation from 2010 through 2016 were included and divided into the three groups according to the ACST; the no ACST group, the incomplete ACST group (inadequate dose of antenatal corticosteroid in pregnancy), and the complete ACST group (recommended dose of antenatal corticosteroid in pregnancy). The effect of risk factors including ACST on clinical outcomes of preterm infants was further explored using logistic regression analysis.
RESULTS
Among 198 infants who fulfilled the study criteria, 32 (16.2%) were classified as the no ACST group, 71 (35.9%) as the incomplete ACST group, and 95 (48.0%) as the complete ACST group. The incidence of low Apgar score at 5-minutes (≤4) was significantly higher in the no ACST group than in the complete ACST group (adjusted odds ratio [OR] 4.49; 95% confidence interval [CI] 1.41-14.32; P=0.011). The incidence of necrotizing enterocolitis (NEC, stage ≥2a) was not different between the no ACST group and the incomplete/the complete group, but significantly higher in the incomplete ACST group than in the complete ACST group (adjusted OR 10.49; 95% CI 1.13-97.28; P=0.039).
CONCLUSION
Incomplete ACST within 24 hours prior to delivery appears to significantly increase NEC (stage ≥2a) in preterm infants born between 24 0/7 and 33 6/7 weeks gestation.

Keyword

Corticosteroid; Preterm infant; Necrotizing enterocolitis

MeSH Terms

Apgar Score
Enterocolitis, Necrotizing
Humans
Incidence
Infant
Infant, Newborn
Infant, Premature*
Logistic Models
Odds Ratio
Pregnancy
Risk Factors

Figure

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  Fig. 1 Flow diagram showing the study design of 198 preterm infants included in this study. ACST, antenatal corticosteroid therapy.

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  Fig. 2 Distribution of gestational age at birth of each subgroup. ACST, antenatal corticosteroid therapy.

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