The Effects of Incomplete Antenatal Corticosteroid Therapy Prior to Delivery on Clinical Outcomes of Preterm Infants

Abstract

Objective: To investigate the effect of incomplete antenatal corticosteroid therapy (ACST) prior to delivery on clinical outcomes of preterm infants. Methods: Preterm infants born between 24 0/7 and 33 6/7 weeks of gestation from 2010 through 2016 were included and divided into the three groups according to the ACST; the no ACST group, the incomplete ACST group (inadequate dose of antenatal corticosteroid in pregnancy), and the complete ACST group (recommended dose of antenatal corticosteroid in pregnancy). The effect of risk factors including ACST on clinical outcomes of preterm infants was further explored using logistic regression analysis. Results: Among 198 infants who fulfilled the study criteria, 32 (16.2%) were classified as the no ACST group, 71 (35.9%) as the incomplete ACST group, and 95 (48.0%) as the complete ACST group. The incidence of low Apgar score at 5-minutes (≤4) was significantly higher in the no ACST group than in the complete ACST group (adjusted odds ratio [OR] 4.49; 95% confidence interval [CI] 1.41-14.32; P=0.011). The incidence of necrotizing enterocolitis (NEC, stage ≥2a) was not different between the no ACST group and the incomplete/the complete group, but significantly higher in the incomplete ACST group than in the complete ACST group (adjusted OR 10.49; 95% CI 1.13-97.28; P=0.039). Conclusion: Incomplete ACST within 24 hours prior to delivery appears to significantly increase NEC (stage ≥2a) in preterm infants born between 24 0/7 and 33 6/7 weeks gestation.