Neonatal Morbidities among Moderately Preterm Infants with and without Exposure to Antenatal Corticosteroids

Abstract

Objective We aimed to compare the rates of “surfactant treated respiratory disease” and other neonatal morbidities among moderately preterm (MPT) infants exposed to no, partial, or a complete course of antenatal corticosteroids (ANS).

Study Design This observational cohort study evaluated MPT infants (29^0/7–33^6/7 weeks' gestational age), born between January 2012 and November 2013 and enrolled in the “MPT Registry” of the National Institute of Child Health and Human Development Neonatal Research Network.

Results Data were available for 5,886 infants, including 676 with no exposure, 1225 with partial, and 3,985 with a complete course of ANS. Among no, partial, and complete ANS groups, respectively, there were significant differences in rates of delivery room resuscitation (4.1, 1.4, and 1.2%), surfactant-treated respiratory disease (26.5, 26.3, and 20%), and severe intracranial hemorrhage (3, 2, and 0.8%). Complete ANS course was associated with lower surfactant-treated respiratory disease, compared with partial ANS (odds ratio [OR] 0.62; 95% confidence interval [CI] 0.52–0.74), and no ANS groups (OR 0.52; 95% CI 0.41–0.66) on adjusted analysis.

Conclusion In MPT infants, ANS exposure is associated with lower delivery room resuscitation, surfactant-treated respiratory disease, and severe intracranial hemorrhage; with the lowest frequency of morbidities associated with a complete course.

Keywords

antenatal steroids - surfactant - gestational age - intracranial hemorrhage - necrotizing enterocolitis

Authors' Contributions

Sanjay Chawla: Conceptualized the study, developed the protocol, created data collection form, reviewed analysis, and drafted first version of the manuscript.

Girija Natarajan: Contributed significantly in the development of the study protocol, participated in analysis, critically reviewed and revised the manuscript, and approved the final version of the manuscript.

Dhuly Chowdhury: Critically reviewed the protocol, participated in the development of data collection tools, conducted the initial data analysis, and critically reviewed and revised the manuscript and approved the final version of the manuscript.

Abhik Das: Critically reviewed the protocol, supervised the analysis, reviewed, and revised the manuscript and approved the final version of the manuscript

Michele Walsh: Contributed significantly in the development of the study protocol, participated in the development of data collection tools, participated in analysis, critically reviewed and revised the manuscript, and approved the final version of the manuscript.

Edward F. Bell: Contributed significantly in the development of the study protocol, participated in the development of data collection tools, participated in analysis, critically reviewed and revised the manuscript, and approved the final version of the manuscript.

Abbot R. Laptook: Contributed significantly in the development of the study protocol, participated in the development of data collection tools, participated in analysis, critically reviewed and revised the manuscript, and approved the final version of the manuscript.

Krisa Van Meurs: Contributed significantly in the development of the study protocol, participated in the development of data collection tools, participated in analysis, critically reviewed and revised the manuscript, and approved the final version of the manuscript.

Carl T. D'Angio: Contributed significantly in development of the study protocol, participated in development of data collection tools, participated in analysis, critically reviewed and revised the manuscript and approved the final version of the manuscript.

Barbara J. Stoll: Contributed significantly in the development of the study protocol, participated in the development of data collection tools, participated in analysis, critically reviewed and revised the manuscript, and approved the final version of the manuscript.

Sara B. DeMauro: Contributed significantly in the development of the study protocol, participated in the development of data collection tools, participated in analysis, critically reviewed and revised the manuscript, and approved the final version of the manuscript.

Seetha Shankaran: Contributed significantly in the development of the study protocol, participated in the development of data collection tools, participated in analysis, critically reviewed and revised the manuscript, and approved the final version of the manuscript.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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