Antenatal corticosteroids-to-birth interval in preterm birth

Area of Science:

• Neonatal research
• Maternal-fetal medicine
• Pediatric outcomes

Background:

• Antenatal corticosteroids (ACS) are administered to women at risk of preterm birth to improve neonatal outcomes.
• The interval between ACS administration and birth is a critical factor influencing treatment efficacy.
• Optimal ACS-to-birth intervals are debated, particularly for infants born at different gestational ages.

Purpose of the Study:

• To compare short-term neonatal outcomes in preterm infants (24-34 weeks' gestation) based on observed antenatal corticosteroid (ACS)-to-birth intervals.
• To determine if variations in ACS-to-birth intervals impact infant outcomes across different gestational ages at birth.

Main Methods:

• A cohort study analyzed 886 children born between 24 and 34 weeks' gestation.
• Infant outcomes were assessed based on the interval between the last ACS dose and birth.
• Generalized estimating equation (GEE) models were used to analyze incidence and rate differences for binary and continuous outcomes.

Main Results:

• No significant differences in birth weight, respiratory outcomes, cerebral outcomes, or composite outcomes were observed between infants born within 7 days of ACS and those born later.
• The distribution of births showed 35.9% within 2 days, 32.2% within 2-7 days, 14.1% within 8-14 days, and 17.8% after 14 days.
• These findings held true across various gestational ages at birth.

Conclusions:

• The clinical value of the observed antenatal corticosteroid (ACS)-to-birth interval is questionable due to its post-hoc nature.
• Predicting preterm birth and determining optimal ACS timing remains challenging, potentially limiting the interval's utility in clinical practice.
• Further research may be needed to refine the understanding and application of ACS timing in preterm birth management.