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Effect of Antenatal Dexamethasone in Late Preterm Period on Neonatal Hypoglycemia: A Prospective Cohort Study from a

Somnath Pal1, Syamal Sardar1, Nirmalya Sarkar1

  • 1Department of Neonatology, IPGME&R, Kolkata 700020, India.

Journal of Tropical Pediatrics
|February 24, 2022
PubMed

Insights

A complete course of antenatal dexamethasone for mothers delivering late preterm infants significantly reduces the risk of neonatal hypoglycemia. This intervention is crucial for improving newborn health outcomes.

Area of Science:

  • Neonatal Medicine
  • Obstetrics
  • Pharmacology

Background:

  • Neonatal hypoglycemia is a significant concern in late preterm infants (34-366/7 weeks' gestational age).
  • Antenatal corticosteroids are used to mature fetal lungs but their effect on neonatal glucose homeostasis requires further investigation.

Purpose of the Study:

  • To compare the risk of hypoglycemia within 72 hours of life in late preterm infants exposed to antenatal dexamethasone versus those not exposed.
  • To evaluate the impact of a complete versus partial course of antenatal steroids on neonatal hypoglycemia.

Main Methods:

  • Prospective cohort study in a tertiary neonatal unit in Eastern India.
  • Infants were categorized into unexposed, partial antenatal dexamethasone course, and complete antenatal dexamethasone course groups.
  • Primary outcome: incidence of hypoglycemia (whole blood glucose <45 mg/dl) within 72 hours of life.

Main Results:

  • A complete course of antenatal dexamethasone significantly reduced hypoglycemia incidence at 72 hours (p=0.005) and 12 hours (p=0.013) compared to no exposure.
  • Hypoglycemia was also significantly less in the complete course group compared to the partial course group at 72 hours (p=0.008) and 12 hours (p=0.013).
  • Logistic regression showed a complete course of antenatal corticosteroids significantly decreased hypoglycemia risk (aOR 0.15, 95% CI 0.03-0.69).

Conclusions:

  • A complete course of antenatal dexamethasone administered to mothers at risk of late preterm delivery effectively reduces the risk of neonatal hypoglycemia.
  • This intervention demonstrates a clear benefit in preventing hypoglycemia within the first 72 hours of life for late preterm infants.
Abstract

Keywords:
antenatal corticosteroidsdexamethasonehypoglycemialate preterm

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