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KMID : 1039920180250040161
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Neonatal Medicine
2018 Volume.25 No. 4 p.161 ~ p.169
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Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction
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Kim Yoo-Jinie
Choi Sung-Hwan
Oh So-Hee
Sohn Jin-A
Jung Young-Hwa
Shin Seung-Han
Choi Chang-Won
Kim Ee-Kyung
Kim Han-Suk
Kim Beyong-Il
Lee Jin-A
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Abstract
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Purpose: We assessed the influence of antenatal corticosteroid (ACS) on the inhospital outcomes of intrauterine growth restriction (IUGR) infants.
Methods: A retrospective study was conducted with singletons born at 23+0 to 33+6 weeks of gestation at Seoul National University Hospital from 2007 to 2014. We compared clinical outcomes between infants who received ACS 2 to 7 days before birth (complete ACS), at <2 or >7 days (incomplete ACS), and those who did not receive ACS in IUGR and AGA infants. Multivariate logistic regression using Firth’s penalized likelihood was performed.
Results: 304 neonates with 91 IUGR neonates were eligible. Among AGA neonates, mortality (adjusted odds ratio [aOR], 0.13; 95% confidence interval [CI], 0.02 to 0.78), hypotension within 7 postnatal days (aOR, 0.20; 95% CI, 0.06 to 0.64), and severe bronchopulmonary dysplasia (BPD) or death (aOR, 0.24; 95% CI, 0.07 to 0.77) were lower in complete ACS group after adjusting for pregnancy induced hypertension and uncontrolled preterm labor. Mortality (aOR, 0.18; 95% CI, 0.04 to 0.78), hypotension (aOR, 0.26; 95% CI, 0.09 to 0.70), and severe BPD or death (aOR, 0.33; 95% CI, 0.12 to 0.92) were also lower in the incomplete ACS group. Among IUGR infants, after adjusting for birth weight and 5-minute Apgar score, inhaled nitric oxide use within 14 postnatal days was lower in both complete ACS (aOR, 0.07; 95% CI, 0.01 to 0.67) and incomplete ACS (aOR, 0.04; 95% CI, 0.01 to 0.37) groups.
Conclusion: ACS was not effective in reducing morbidities in IUGR preterm infants.
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KEYWORD
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Prenatal care, Steroids, Fetal growth retardation, Premature infant, Outcome assessment (health care)
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