PURPOSE: We sought to determine if administration of antenatal corticosteroids in early preterm births (<34 weeks) is associated with an increased risk of developing neonatal hypoglycemia (<40 mg/dL) within the first 48 h of neonatal life. MATERIALS AND METHODS: Retrospective cohort of all indicated singleton preterm births (23-34 weeks) in a single tertiary center from 2011 to 2014. The primary outcome was neonatal hypoglycemia (<40 mg/dL) within the first 48 h of life. The outcome was compared by antenatal corticosteroids received at any point during the gestation, within 2-7 d of delivery, and whether the patient received a partial, full, or repeat course of antenatal corticosteroids. Logistic regression was used to adjust for confounders. RESULTS: Six hundred thirty-five patients underwent an indicated preterm birth during the study period. Six hundred and four (95%) received antenatal corticosteroids prior to delivery and 31 (5%) did not. The incidence of neonatal hypoglycemia within 48 h of life was not significantly different between those who received any antenatal corticosteroids and those who did not (23.0 versus 16.1%, adjusted odds ratio [OR] 1.3, 95%CI 0.5-3.6). Infants who received a full antenatal corticosteroid course within 2-7 d of delivery had similar incidences of hypoglycemia compared with those who received antenatal corticosteroids more than 7 d before delivery (20.4 versus 25.4%, adjusted OR 1.5, 95% confidence interval(CI) 0.8-2.9). Neonatal hypoglycemia was not increased by the number of antenatal corticosteroid doses (partial, full, or repeat course) administered. There was not a correlation between timing of antenatal corticosteroid administration before delivery, up to 250 h, and the lowest neonatal blood sugar in the first 48 h of life. CONCLUSION: Our findings suggest antenatal corticosteroid administration in indicated early preterm infants (<34 weeks) may not increase the risk of developing neonatal hypoglycemia within the first 48 h of life. Further studies should validate our findings.
PURPOSE: We sought to determine if administration of antenatal corticosteroids in early preterm births (<34 weeks) is associated with an increased risk of developing neonatal hypoglycemia (<40 mg/dL) within the first 48 h of neonatal life. MATERIALS AND METHODS: Retrospective cohort of all indicated singleton preterm births (23-34 weeks) in a single tertiary center from 2011 to 2014. The primary outcome was neonatal hypoglycemia (<40 mg/dL) within the first 48 h of life. The outcome was compared by antenatal corticosteroids received at any point during the gestation, within 2-7 d of delivery, and whether the patient received a partial, full, or repeat course of antenatal corticosteroids. Logistic regression was used to adjust for confounders. RESULTS: Six hundred thirty-five patients underwent an indicated preterm birth during the study period. Six hundred and four (95%) received antenatal corticosteroids prior to delivery and 31 (5%) did not. The incidence of neonatal hypoglycemia within 48 h of life was not significantly different between those who received any antenatal corticosteroids and those who did not (23.0 versus 16.1%, adjusted odds ratio [OR] 1.3, 95%CI 0.5-3.6). Infants who received a full antenatal corticosteroid course within 2-7 d of delivery had similar incidences of hypoglycemia compared with those who received antenatal corticosteroids more than 7 d before delivery (20.4 versus 25.4%, adjusted OR 1.5, 95% confidence interval(CI) 0.8-2.9). Neonatal hypoglycemia was not increased by the number of antenatal corticosteroid doses (partial, full, or repeat course) administered. There was not a correlation between timing of antenatal corticosteroid administration before delivery, up to 250 h, and the lowest neonatal blood sugar in the first 48 h of life. CONCLUSION: Our findings suggest antenatal corticosteroid administration in indicated early preterm infants (<34 weeks) may not increase the risk of developing neonatal hypoglycemia within the first 48 h of life. Further studies should validate our findings.
Authors: Olufemi T Oladapo; Joshua P Vogel; Gilda Piaggio; My-Huong Nguyen; Fernando Althabe; A Metin Gülmezoglu; Rajiv Bahl; Suman P N Rao; Ayesha De Costa; Shuchita Gupta; Abdullah H Baqui; Rasheda Khanam; Mohammod Shahidullah; Saleha B Chowdhury; Salahuddin Ahmed; Nazma Begum; Arunangshu D Roy; M A Shahed; Iffat A Jaben; Farida Yasmin; M Mozibur Rahman; Anjuman Ara; Soofia Khatoon; Gulshan Ara; Shaheen Akter; Nasreen Akhter; Probhat R Dey; M Abdus Sabur; Mohammad T Azad; Shahana F Choudhury; M A Matin; Shivaprasad S Goudar; Sangappa M Dhaded; Mrityunjay C Metgud; Yeshita V Pujar; Manjunath S Somannavar; Sunil S Vernekar; Veena R Herekar; Shailaja R Bidri; Sangamesh S Mathapati; Preeti G Patil; Mallanagouda M Patil; Muttappa R Gudadinni; Hidaytullah R Bijapure; Ashalata A Mallapur; Geetanjali M Katageri; Sumangala B Chikkamath; Bhuvaneshwari C Yelamali; Ramesh R Pol; Sujata S Misra; Leena Das; Saumya Nanda; Rashmita B Nayak; Bipsa Singh; Zahida Qureshi; Fredrick Were; Alfred Osoti; George Gwako; Ahmed Laving; John Kinuthia; Hafsa Mohamed; Nawal Aliyan; Adelaide Barassa; Elizabeth Kibaru; Margaret Mbuga; Lydia Thuranira; Njoroge J Githua; Bernadine Lusweti; Adejumoke I Ayede; Adegoke G Falade; Olubukola A Adesina; Atinuke M Agunloye; Oluwatosin O Iyiola; Wilfred Sanni; Ifeyinwa K Ejinkeonye; Hadiza A Idris; Chinyere V Okoli; Theresa A Irinyenikan; Omolayo A Olubosede; Olaseinde Bello; Olufemi M Omololu; Olanike A Olutekunbi; Adesina L Akintan; Olorunfemi O Owa; Rosena O Oluwafemi; Ireti P Eniowo; Adetokunbo O Fabamwo; Elizabeth A Disu; Joy O Agbara; Ebunoluwa A Adejuyigbe; Oluwafemi Kuti; Henry C Anyabolu; Ibraheem O Awowole; Akintunde O Fehintola; Bankole P Kuti; Anthony D Isah; Eyinade K Olateju; Olusanya Abiodun; Olabisi F Dedeke; Francis B Akinkunmi; Lawal Oyeneyin; Omotayo Adesiyun; Hadijat O Raji; Adedapo B A Ande; Ikechukwu Okonkwo; Shabina Ariff; Sajid B Soofi; Lumaan Sheikh; Saima Zulfiqar; Sadia Omer; Raheel Sikandar; Salma Sheikh; Daniel Giordano; Hugo Gamerro; Guillermo Carroli; Jose Carvalho; James Neilson; Elizabeth Molyneux; Khalid Yunis; Kidza Mugerwa; Harish K Chellani Journal: N Engl J Med Date: 2020-10-23 Impact factor: 91.245