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KMID : 0358420110540100582
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Korean Journal of Obstetrics and Gynecology
2011 Volume.54 No. 10 p.582 ~ p.590
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The effect of antenatal corticosteroid on incidence of respiratory distress syndrome according to maternal body mass index
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Cho Eun-Ju
Kwak Hye-Min
Ji Hyun-Young
Cha Hyun-Hwa
Choi Suk-Joo
Oh Soo-Young
Roh Cheong-Rae
Kim Jong-Hwa
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Abstract
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Objective:To investigate the effects of antenatal corticosteroid (ACS) on incidence of neonatal respiratory distress syndrome (RDS) according to maternal body mass index (BMI).
Methods:We retrospectively reviewed the medical records of 715 singleton pregnant women who delivered between 24+0 and 34+0 weeks of gestation, from January 1996 to December 2006. Subjects were categorized into three groups according to ACS exposure: a nonuser group (n = 244), a single-course group (n = 377) and a multiple-course group (n = 94). Subjects were re-categorized into three groups according to maternal BMI at admission: group 1 (BMI < 23.0 kg/m2, n = 234), group 2 (BMI 23.0-24.9 kg/m2, n = 166) and group 3 (BMI ≥ 25.0 kg/m2, n = 315). Univariate and multiple logistic regression analyses were used for the statistical analysis.
Results:Overall, the incidence of RDS was significantly lower in ACS-user groups than the non-user group, with lowest incidence in the multiple-course group (non-user vs. single-course vs. multiple-course: 44.3% vs. 41.1% vs. 11.7%, P < 0.001). The incidence of RDS was not different among the three BMI groups. Multiple logistic regression analysis showed that single- and multiple-course of ACS was significantly associated with reduced incidence of RDS: single-course, odds ratio (OR) 0.593, 95% confidence interval (CI) 0.373, 0.942; multiple-course, OR 0.085, 95% CI 0.034, 0.213. However, maternal BMI was not associated with reduced incidence of RDS with different ACS-courses (P for interaction = 0.690).
Conclusion:ACS therapy, especially when multiple-course was used, was significantly associated with reduced incidence of RDS, but maternal BMI did not influence its effectiveness.
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KEYWORD
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Preterm delivery, Antenatal corticosteroid, Respiratory distress syndrome, Maternal body mass index
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