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

INTRODUCTION

There is a need for a better understanding of the use of antenatal steroids (ANS) in late preterm infants due to their efficacy and safety profile from existing evidence.

AIMS: To identify the real-world impact of ANS on short-term outcomes in late preterm infants at a quaternary care setting in Qatar.

METHODS

Retrospective chart review of 654 late preterm infants delivered at Sidra Medicine between 1st January 2018 and 29th February 2024. After excluding criteria, infants were categorized based on their exposure to ANS. We utilized regression models to analyze the relationship between ANS exposure and primary and secondary outcomes, including respiratory distress, Noninvasive respiratory support, hypoglycemia, and length of NICU stay, respectively, while adjusting for relevant maternal and infant characteristics.

RESULTS

Our findings reveal no significant protective effect of any ANS dosage against respiratory distress (adjusted odd ratio (aOR) 0.78; 95% CI: 0.46-1.32; p = 0.357). Conversely, ANS exposure was associated with an increased risk of hypoglycemia (aOR 1.22; 95% CI: 0.81-1.84; p = 0.350) and prolonged stay in NICU (incidence rate ratio [IRR] 1.90; 95% CI: 1.74-2.08; p < 0.001).

CONCLUSION

Our study findings suggest a lack of protection against respiratory distress in late preterm infants with any ANS, highlighting the need for better understanding and adopting an individualized approach.