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Updated: Oct 2, 2026

Intratracheal Instillation of Stem Cells in Term Neonatal Rats
Published on: May 4, 2020
Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates
Beverly A Banks1, George Macones, Avital Cnaan
1Department of Pediatrics, University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, Division of Neonatology, Philadelphia, PA 19104, USA.
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.
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