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Late preterm antenatal steroid use and infant outcomes in a single center

Abstract

Objective

To characterize late preterm antenatal steroids (AS) use and associated neonatal outcomes in a single academic center.

Study design

Retrospective study of 503 singleton, mother-infant dyads delivered between 34 0/7 and 36 6/7 weeks gestation between January 1, 2016 and December 31, 2020.

Results

Forty-three percent did not receive AS (No AS) prior to delivery. Among AS treated, 50% were sub-optimal dosing. No AS had higher preterm premature rupture of membranes and maternal diabetes. AS group had lower mean gestational age, birthweight, longer time from admission to delivery and longer NICU stay. There was no difference in neonatal hypoglycemia.

Conclusions

Sub-optimal AS dosing in late preterms remains high in our center. AS did not improve neonatal outcomes. Studies are needed to evaluate the impact of AS in diabetics delivering late preterm, to optimize the timing of AS dosing, and evaluate the longer term impact on late preterm infants.

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Data availability

The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Society for Maternal-Fetal Medicine. Electronic address pso, Reddy UM, Deshmukh U, Dude A, Harper L, Osmundson SS. Society for Maternal-Fetal Medicine Consult Series #58: Use of antenatal corticosteroids for individuals at risk for late preterm delivery: Replaces SMFM Statement #4, Implementation of the use of antenatal corticosteroids in the late preterm birth period in women at risk for preterm delivery, August 2016. Am J Obstet Gynecol. 2021;225:B36–B42.

    Article  Google Scholar 

  2. Committee on Obstetric P. Committee opinion no. 713: antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol. 2017;130:e102–e9.

    Article  Google Scholar 

  3. Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita AT, Reddy UM, Saade GR, et al. Antenatal betamethasone for women at risk for late preterm delivery. N Engl J Med. 2016;374:1311–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Uquillas KR, Lee RH, Sardesai S, Chen E, Ihenacho U, Cortessis VK, et al. Neonatal hypoglycemia after initiation of late preterm antenatal corticosteroids. J Perinatol. 2020;40:1339–48.

    Article  CAS  PubMed  Google Scholar 

  5. Kemp MW, Jobe AH, Usuda H, Nathanielsz PW, Li C, Kuo A, et al. Efficacy and safety of antenatal steroids. Am J Physiol Regul Integr Comp Physiol. 2018;315:R825–R39.

    Article  CAS  PubMed  Google Scholar 

  6. Deshmukh M, Patole S. Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries-A systematic review and meta-analysis of RCTs. PLoS One. 2021;16:e0248774.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Raikkonen K, Gissler M, Tapiainen T, Kajantie E. Associations between maternal antenatal corticosteroid treatment and psychological developmental and neurosensory disorders in children. JAMA Netw Open. 2022;5:e2228518.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Collaborators WAT. Antenatal dexamethasone for late preterm birth: a multi-centre, two-arm, parallel, double-blind, placebo-controlled, randomized trial. EClinicalMedicine. 2022;44:101285.

    Article  Google Scholar 

  9. Battarbee AN, Clapp MA, Boggess KA, Kaimal A, Snead C, Schulkin J, et al. Practice variation in antenatal steroid administration for anticipated late preterm birth: a physician survey. Am J Perinatol. 2019;36:200–4.

    Article  PubMed  Google Scholar 

  10. McElwee ER, Wilkinson K, Crowe R, Newman JC, Alkis M, Wineland R, et al. Indication creep of antenatal late preterm steroids. Am J Perinatol. 2022;39:1159–65.

    Article  PubMed  Google Scholar 

  11. ACOG Practice Bulletin No. 190. Gestational diabetes mellitus. Obstet Gynecol. 2018;131:e49–e64.

    Article  Google Scholar 

  12. McEvoy C, Bowling S, Williamson K, Stewart M, Durand M. Functional residual capacity and passive compliance measurements after antenatal steroid therapy in preterm infants. Pediatr Pulmonol. 2001;31:425–30.

    Article  CAS  PubMed  Google Scholar 

  13. McEvoy C, Bowling S, Williamson K, Collins J, Tolaymat L, Maher J. Timing of antenatal corticosteroids and neonatal pulmonary mechanics. Am J Obstet Gynecol. 2000;183:895–9.

    Article  CAS  PubMed  Google Scholar 

  14. McEvoy C, Bowling S, Williamson K, Lozano D, Tolaymat L, Izquierdo L, et al. The effect of a single remote course versus weekly courses of antenatal corticosteroids on functional residual capacity in preterm infants: a randomized trial. Pediatrics. 2002;110:280–4.

    Article  PubMed  Google Scholar 

  15. McEvoy C, Schilling D, Peters D, Tillotson C, Spitale P, Wallen L, et al. Respiratory compliance in preterm infants after a single rescue course of antenatal steroids: a randomized controlled trial. Am J Obstet Gynecol. 2010;202:544 e1–9.

    Article  PubMed  Google Scholar 

  16. Go M, Schilling D, Nguyen T, Durand M, McEvoy CT. Respiratory compliance in late preterm infants (34(0/7)-34(6/7) weeks) after antenatal steroid therapy. J Pediatr. 2018;201:21–6.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Brand PL, Molenaar NL, Kaaijk C, Wierenga WS. Neurodevelopmental outcome of hypoglycaemia in healthy, large for gestational age, term newborns. Arch Dis Child. 2005;90:78–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Burns CM, Rutherford MA, Boardman JP, Cowan FM. Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics. 2008;122:65–74.

    Article  PubMed  Google Scholar 

  19. Duvanel CB, Fawer CL, Cotting J, Hohlfeld P, Matthieu JM. Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational-age preterm infants. J Pediatr. 1999;134:492–8.

    Article  CAS  PubMed  Google Scholar 

  20. Kerstjens JM, Bocca-Tjeertes IF, de Winter AF, Reijneveld SA, Bos AF. Neonatal morbidities and developmental delay in moderately preterm-born children. Pediatrics. 2012;130:e265–72.

    Article  PubMed  Google Scholar 

  21. Lucas A, Morley R, Cole TJ. Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia. BMJ. 1988;297:1304–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Tam EW, Haeusslein LA, Bonifacio SL, Glass HC, Rogers EE, Jeremy RJ, et al. Hypoglycemia is associated with increased risk for brain injury and adverse neurodevelopmental outcome in neonates at risk for encephalopathy. J Pediatr. 2012;161:88–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Tin W, Brunskill G, Kelly T, Fritz S. 15-year follow-up of recurrent “hypoglycemia” in preterm infants. Pediatrics. 2012;130:e1497–503.

    Article  PubMed  Google Scholar 

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Funding

Funding

This work was supported by 2 KL2 TR002370-06(MDG); NHLBI R01 HL105447 with co-funding from the Office of Dietary Supplements (ODS), NIH UH3OD023288 from the Environmental influences on Child Health Outcomes Program (ECHO), NIH R33HL147906 (CMT). Additional support from the Oregon Clinical Translational Research Institute funded by the National Center for Advancing Translational Sciences (UL1TR002369).

Author information

Authors and Affiliations

Authors

Contributions

MG and CM conceived and designed the study, contributed to data analysis and interpretation; MG wrote the manuscript with support from MW, TK, and CM. MW and TK collected data and performed the data analysis. All authors discussed the results and contributed to the final version of the manuscript.

Corresponding author

Correspondence to Mitzi Go.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval

The study was approved by the Oregon Health & Science University Institutional Review Board (IRB Study#22726) and was performed in accordance with the Declaration of Helsinki.

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Go, M., Wahl, M., Kruss, T. et al. Late preterm antenatal steroid use and infant outcomes in a single center. J Perinatol 44, 1009–1013 (2024). https://doi.org/10.1038/s41372-024-01934-2

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