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KMID : 0358420070500050741
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Korean Journal of Obstetrics and Gynecology
2007 Volume.50 No. 5 p.741 ~ p.750
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The effect of multiple courses of antenatal corticosteroid therapy on perinatal outcome of the preterm neonates
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Cho Hyun-Ji
Seo Eun-Sung
Song Seung-Eun
Jung Kyung-Lan
Choi Suk-Joo
Oh Soo-Young
Kim Jong-Hwa
Roh Cheong-Rae
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Abstract
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Objective: To investigate the effect of multiple courses of antenatal corticosteroid (ACS) therapy on perinatal outcomes, especially the respiratory distress syndrome (RDS), of the premature neonates.
Methods: We retrospectively evaluated the pregnancy and neonatal outcomes of 622 singleton pregnancies delivered at 24-34 weeks of gestation from January 1996 to December 2005. Subjects were categorized into three groups according to ACS exposure: (1) a non-user group (n=234), (2) a single-course group (n=299) and (3) a repeated-course group (n=89). Univariate and multiple logistic regression analyses were used for the incidences of RDS.
Results: Pregnancy outcomes including gestational age at delivery, occurrence of clinical and histological chorioamnionitis, birth weight, neonatal intensive care unit (NICU) admission rate, duration of NICU stay and neonatal mortality were similar in the three groups. The incidence of RDS was significantly lower in ACS user groups than the non-user group, with lowest incidence in multiple-course group (44.9% vs. 37.8% vs. 12.4%, p<0.001). The incidence of bronchopulmonary dysplasia and overall neonatal composite morbidity were also lowest in multiple-course group. Multivariate analysis showed that multiple courses of ACS were associated with reduced incidence of RDS (OR 0.100, 95% CI 0.042, 0.240, p<0.001) independently with gestational age at delivery, admission-to-delivery interval and premature rupture of membranes.
Conclusion: Multiple courses of ACS administered to women with risk of preterm delivery were found to be associated with decreased incidence of RDS of the premature neonates.
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KEYWORD
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Antenatal corticosteroid, Preterm delivery, Multiple courses, Perinatal outcome, Respiratory distress syndrome
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