Antenatal Corticosteroids Decrease the Risk of Composite Neonatal Respiratory Morbidity in Planned Early Term...

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Perinatology

Background:

• Antenatal corticosteroids are not standard practice in the US before elective cesarean deliveries.
• International trials show benefits in reducing neonatal respiratory issues.

Purpose of the Study:

• To determine if antenatal corticosteroids for fetal lung maturation before early term cesarean delivery decrease composite respiratory morbidity.
• To assess the impact of antenatal corticosteroids on neonatal respiratory outcomes in scheduled early term cesarean deliveries.

Main Methods:

• Historical cohort study at Mount Sinai Hospital (May 2015-August 2019).
• Compared neonates born via scheduled early term cesarean delivery who received antenatal corticosteroids within 1 week of delivery versus those who did not.
• Primary outcome: composite respiratory morbidity (respiratory distress syndrome, transient tachypnea of the newborn, NICU admission for respiratory issues).

Main Results:

• Neonates not exposed to antenatal corticosteroids had a 4.1 times higher risk of composite respiratory morbidity (p=0.02).
• The risk was significantly higher for neonates born between 37 and 38 weeks gestation who did not receive steroids (RR 11.7, p<0.01).
• No significant difference was observed for neonates born between 38 and 39 weeks.

Conclusions:

• Betamethasone administration before planned early term cesarean delivery significantly reduces neonatal composite respiratory morbidity.
• Steroid administration was most beneficial for neonates delivered between 37 and 38 weeks.
• No increased adverse neonatal outcomes were associated with antenatal steroid administration.