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Antenatal corticosteroids affecting enteral feeding and growth of preterm infants: A retrospective cohort study
Ping Luo1, Xudong Liu1, Liya Ma2
1School of Public Health, Sun Yat-sen University, Guangzhou, China.
Insights
Antenatal corticosteroids (ACSs) may negatively impact preterm infant feeding and growth, particularly in later preterm infants. Further research is needed to confirm these effects and understand their mechanisms.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Perinatology
Background:
- Antenatal corticosteroids (ACSs) reduce neonatal mortality and morbidity in preterm births.
- The impact of ACS exposure on enteral feeding and growth in preterm infants is not well understood.
Purpose of the Study:
- To investigate the association between antenatal corticosteroid exposure and outcomes of enteral feeding and body growth in preterm infants.
- To explore potential differences in these associations based on gestational age.
Main Methods:
- Retrospective study of singleton infants born between 22 and 36 weeks' gestation (2017-2019).
- Logistic and multivariate linear regression analyses were used to assess ACS exposure effects on feeding and growth, controlling for confounders.
- Stratified analysis was conducted based on gestational age (<34 vs. ≥34 weeks).
Main Results:
- Infants exposed to ACSs showed increased feeding intolerance (OR 1.51), slower enteral feeding advancement (β -0.86), and reduced body-weight z-scores (β -0.13).
- These adverse effects were more pronounced in late preterm infants (GA ≥34 weeks), including longer time to regain birth weight.
- No significant association was observed in infants with GA <34 weeks.
Conclusions:
- Antenatal corticosteroid exposure is linked to impaired enteral feeding and body growth in preterm infants.
- The negative impact of ACSs on feeding and growth is more significant in late preterm infants.
- Further prospective and mechanistic studies are warranted to elucidate these findings.
Background:
Treatment of antenatal corticosteroids (ACSs) to women at risk of preterm labor can decrease neonatal mortality and morbidity. However, effect of ACS exposure on enteral feeding and body growth of preterm infants remains elusive.
Methods:
This retrospective study collected information of eligible singleton infants born between 22+0 and 36+6 weeks' gestation from 2017 to 2019. Logistic regression and multivariate linear regression were adopted to examine the associations of the ACS exposure with various outcomes of enteral feeding and growth considering potential confounders. Stratified analysis was performed based on gestational age (GA) (<34 vs ≥34 weeks).
Results:
Of the 1694 preterm infants included, 1222 (72.1%) were exposed to ACSs. Infants with ACS exposure had a higher incidence of feeding intolerance (odds ratio 1.51; 95% CI, 1.05 to 2.20; P = .03), slower advancement of enteral feeding (β coefficient -0.86; 95% CI, -1.48 to -0.25; P = .01), and lower delta body-weight z-scores (β coefficient-0.13; 95% CI, -0.18 to -0.08; P < .001). Unlike in infants with GA <34 weeks, ACS exposure was associated with slower advancement of enteral feeding, longer time to regain birth weight, and lower delta body-weight z-scores in the ones with GA ≥34 weeks.
Conclusion:
ACS exposure is associated with poorer enteral feeding process and body growth in our study population, which is more prominent in late preterm infants. A multicenter prospective study and mechanistic studies using animal models are required.
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