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Antenatal corticosteroid administration-to-birth interval and neonatal outcomes in very preterm infants: A secondary

Duan Wang1, Li Ming2, Yong Zhu3

  • 1Department of Rehabilitation, Children's Hospital of Chongqing Medical University, Chongqing, China.

Plos One
|February 10, 2023
PubMed

Insights

A longer interval of antenatal corticosteroids (ACS) greater than 48 hours before birth significantly improves survival and reduces complications in very preterm infants. This finding supports optimizing ACS timing for better neonatal outcomes.

Area of Science:

  • Neonatal Medicine
  • Obstetrics
  • Pediatric Critical Care

Background:

  • Antenatal corticosteroids (ACS) are crucial for preventing neonatal complications in preterm infants.
  • Current guidelines recommend ACS administration within 7 days of preterm birth, but optimal timing remains unclear.
  • Evidence supporting narrower optimal ACS administration-to-birth intervals is limited.

Purpose of the Study:

  • To investigate the association between ACS administration-to-birth intervals (specifically <48 hours vs. >48 hours) and neonatal outcomes in very preterm infants.
  • To provide evidence for optimizing the timing of ACS administration.
  • To inform clinical guidelines regarding ACS use.

Main Methods:

  • A single-center prospective observational study.
  • Data from eligible infants (January 2008 - April 2014) were analyzed.
  • Neonatal outcomes were compared between infants receiving ACS <48 hours and >48 hours before birth.

Main Results:

  • The >48-hour ACS interval group showed significantly reduced mortality (OR: 0.17).
  • Reduced rates of any retinopathy of prematurity (OR: 0.36) and severe retinopathy of prematurity (OR: 0.07) were observed in the >48-hour group.
  • The >48-hour interval was associated with less need for intubation (OR: 0.39) and higher 1-minute Apgar scores (β: 0.56).

Conclusions:

  • An ACS administration-to-birth interval greater than 48 hours demonstrates a significant health promotion effect in very preterm infants.
  • This extended interval is associated with improved survival and reduced major neonatal morbidities.
  • Findings suggest that a >48-hour interval may be optimal for ACS administration.
Abstract

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