Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates.

Journal of perinatology : official journal of the California Perinatal Association

2002

https://researcherprofiles.org/profile/1427269

11896513

Banks BA, Macones G, Cnaan A, Merrill JD, Ballard PL, Ballard RA, North American TRH Study Group

Abstract

OBJECTIVE

Determine whether the increased neonatal mortality following repeated courses of antenatal corticosteroids (ANCS), observed in the Thyrotropin-Releasing Hormone (TRH) Trial, was related to confounding maternal risk factors or specific preterm morbidities.

STUDY DESIGN

A post hoc analysis of 595 TRH trial neonates, 26 to 32 weeks' gestation, studied the association between > or =3 courses ANCS and mortality. Potential confounding maternal factors and preterm morbidities were evaluated using logistic regression and log likelihood modeling.

RESULTS

Mortality was 9.2% after > or =3 courses (13/141) vs. 4.8% after 1 or 2 courses (22/454). This association was not explained by maternal factors, or other common preterm morbidities. However, 15/141 infants receiving > or =3 courses (10.6%) had early severe lung disease (ESLD) with 10 deaths, compared to 16/454 of the 1- to 2-course infants (3.5%) with 7 deaths (odds ratio 3.5, p<0.001).

CONCLUSIONS

ESLD, but not maternal risk factors, was associated with increased mortality in preterm infants after > or =3 courses ANCS.

Journal Issue

Volume 22 of Issue 2