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Antenatal Late Preterm Infants Exposure to Steroids (ALPINES) and Risk of Respiratory Distress and Hypoglycemia: A

Naveed Ur Rehman Durrani1,2, Maria Bashir Ibrahim Mohammed1, Farhan Sachal Cyprian3

  • 1Department of Pediatrics, Neonatal Division, Sidra Medicine, Doha, Qatar.

Pediatric Pulmonology
|October 15, 2025
PubMed

Insights

Antenatal steroids (ANS) did not protect late preterm infants from respiratory distress. Instead, ANS exposure was linked to increased hypoglycemia and longer NICU stays, suggesting a need for individualized treatment approaches.

Area of Science:

  • Neonatal Medicine
  • Perinatal Research
  • Clinical Obstetrics

Background:

  • Antenatal steroids (ANS) are crucial for fetal lung maturation.
  • Evidence on ANS efficacy and safety in late preterm infants requires further investigation.
  • Understanding real-world outcomes of ANS in this population is essential.

Purpose of the Study:

  • To evaluate the impact of antenatal steroids (ANS) on short-term outcomes in late preterm infants.
  • To assess the association between ANS exposure and respiratory distress, hypoglycemia, and NICU length of stay.
  • To provide real-world data from a quaternary care setting in Qatar.

Main Methods:

  • Retrospective chart review of 654 late preterm infants.
  • Infants categorized by antenatal steroid (ANS) exposure.
  • Regression models used to analyze outcomes, adjusting for covariates.

Main Results:

  • No significant protective effect of ANS against respiratory distress was observed (aOR 0.78; p=0.357).
  • ANS exposure was associated with an increased risk of hypoglycemia (aOR 1.22; p=0.350).
  • A significant increase in NICU length of stay was noted with ANS exposure (IRR 1.90; p<0.001).

Conclusions:

  • Antenatal steroids (ANS) did not demonstrate protection against respiratory distress in late preterm infants.
  • Findings suggest potential increased risks of hypoglycemia and prolonged NICU stays with ANS.
  • An individualized approach to ANS use in late preterm infants is warranted.
Abstract

Keywords:
ICU admissionantenatal steriodscritical careevidence‐based medicine & outcomeshypoglycemiainfant pulmonary functionlate pretermmechanical ventilationrespiratory distressrespiratory distress syndrome & ARDS

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