Antenatal corticosteroids and neonatal outcomes in preterm birth in the United States

Moti Gulersen; Amos Grunebaum; Erez Lenchner; Frank A. Chervenak; Eran Bornstein

doi:10.1515/jpm-2022-0002

Article

Antenatal corticosteroids and neonatal outcomes in preterm birth in the United States

Moti Gulersen , Amos Grunebaum , Erez Lenchner , Frank A. Chervenak and Eran Bornstein

Published/Copyright: February 21, 2022

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From the journal Journal of Perinatal Medicine Volume 50 Issue 5

Abstract

Objectives

To determine the impact of antenatal corticosteroids (ACS) on neonatal outcomes in a large United States population of preterm births.

Methods

Retrospective cohort study utilizing the United States Natality Live Birth database from the Centers for Disease Control and Prevention (2016–2017). Women with singleton preterm births were eligible for inclusion. Out-of-hospital births, fetal anomalies, and cases where ACS exposure was unknown were excluded. Neonates from reported live births were divided into two groups based on whether the mother received ACS before delivery or not. The incidence of several reported neonatal outcomes were compared between the two groups at each gestational week. Subsequently, comparisons between three gestational age groups (23 0/7 to 27 6/7, 28 0/7 to 33 6/7, and 34 to 36 6/7 weeks) were performed. Statistical analysis included use of Chi-squared test and multivariate logistic regression.

Results

Of the 588,077 live births included, 121,151 (20.6%) had been exposed to ACS. ACS use was associated with a significantly decreased odds of neonatal mortality and 5-min Apgar score <7, but an increased rate of several neonatal outcomes such as surfactant replacement therapy, prolonged ventilation, antibiotics for suspected neonatal sepsis, and neonatal intensive care unit (NICU) admissions.

Conclusions

ACS administration prior to preterm birth is associated with a decrease in neonatal mortality and low Apgar scores, and increased odds of several adverse neonatal outcomes.

Keywords: betamethasone; dexamethasone; neonatal morbidity; neonatal mortality; prematurity

Corresponding author: Moti Gulersen, MD, MSc, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, North Shore University Hospital – Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA, Phone: +516 562 2892, E-mail: mgulersen1@northwell.edu

This research was presented, in part, as a poster presentation (final abstract number 329) at the 40th annual meeting of the Society of Maternal–Fetal Medicine in Grapevine, TX, February 3rd–8th, 2020.

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Not applicable.
Ethical approval: IRB approval was not required for this study.

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Received: 2022-01-03

Accepted: 2022-02-04

Published Online: 2022-02-21

Published in Print: 2022-06-27

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Articles in the same Issue

https://doi.org/10.1515/jpm-2022-0002

Keywords for this article

betamethasone; dexamethasone; neonatal morbidity; neonatal mortality; prematurity