Neonatal outcomes based on antenatal corticosteroid exposure time for infants delivered between 23 and 34 weeks gestation.

OBJECTIVE

To determine the minimal time interval required after antenatal corticosteroid treatment to see improvement in neonatal outcomes.

STUDY

DESIGN

A retrospective cohort analysis was performed on all women who delivered an infant between 23 0/7 weeks and 33 6/7 weeks gestational age from January 1, 2009 to August 31, 2013. Maternal data collected: maternal race, parity, mode of delivery, indication for delivery, infant birth weight, antenatal corticosteroid (ACS) administration, and time from ACS until delivery. Neonatal data collected: respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), sepsis, retinopathy of prematurity (ROP), intubation, surfactant administration, length of hospitalization, and mortality.

RESULTS

Infants were grouped by ACS exposure time before delivery. Gestational age at delivery was similar between the groups. There was not a statisti- cally significant difference in the rate of RDS between the groups. Infants delivered 24 to 47 hours of ACS had the lowest rates of surfactant, intubation, and IVH. There appears to be a larger impact ofACS on infants delivered at 29 to 34 weeks vs. 23-28 weeks gestation.

CONCLUSIONS

Improvement in neonatal outcomes are seen after any amount of ACS exposure but are generally most significant 24 to 47 hours after administration and between 29 to 34 weeks gestation.