Antenatal corticosteroids in diabetic pregnancies and outcomes of very preterm infants: a national multicenter cohort study
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View abstract on PubMed
Summary
This summary is machine-generated.Antenatal corticosteroids (ACS) reduce preterm infant mortality and morbidity in diabetic pregnancies. While associated with increased maternal chorioamnionitis risk, ACS improves outcomes like respiratory distress syndrome and bronchopulmonary dysplasia in very preterm infants.
Area Of Science
- Neonatal Medicine
- Maternal-Fetal Medicine
- Pharmacology
Background
- Antenatal corticosteroids (ACS) are standard for preterm birth (<34 weeks) to reduce neonatal morbidity/mortality.
- Evidence for ACS use in diabetic pregnancies is limited, leading to inconsistent guidelines.
- Diabetic pregnancies face higher risks of preterm birth and associated neonatal complications.
Purpose Of The Study
- To evaluate the association between ACS exposure and in-hospital outcomes in very preterm infants (VPIs) born to diabetic mothers.
- To provide specific evidence on the efficacy and safety of ACS in this understudied population.
Main Methods
- A national multicenter cohort study (Chinese Neonatal Network) of 31,915 VPIs from 79 NICUs.
- Analysis included 4,337 VPIs born to mothers with diabetes, comparing ACS exposure (3605) vs. no exposure (732).
- Logistic regression models assessed associations between ACS and mortality/morbidity, with stratification and sensitivity analyses.
Main Results
- ACS was linked to lower risks of combined outcomes (death/severe morbidity), in-hospital death, severe bronchopulmonary dysplasia (BPD), low Apgar score, respiratory distress syndrome (RDS), and invasive ventilation.
- Adjusted ORs showed significant reductions for these outcomes in the ACS group.
- A significantly higher risk of maternal chorioamnionitis was observed in the ACS group (aOR 2.09).
Conclusions
- In VPIs of diabetic mothers, ACS is associated with reduced neonatal mortality and morbidity, including BPD, RDS, and need for ventilation.
- Findings support a favorable risk-benefit profile for ACS in diabetic pregnancies despite increased maternal chorioamnionitis risk.
- This study provides crucial evidence supporting ACS use in diabetic pregnancies at risk of preterm delivery.
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