Yoav Siegler1, N Justman2, G Bachar2, R Lauterbach2, Y Zipori2, N Khatib2, Z Weiner2,3, D Vitner2. 1. Department of Obstetrics and Gynecology, Rambam Medical Center, Aalya St., Haifa, Israel. yoav.siegler@gmail.com. 2. Department of Obstetrics and Gynecology, Rambam Medical Center, Aalya St., Haifa, Israel. 3. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Abstract
OBJECTIVE: We assessed the association between a short antenatal corticosteroid administration-to-birth interval and neonatal outcome. STUDY DESIGN: A retrospective study was conducted between 2010 and 2020. Eligible cases were singleton preterm live-born neonates born between 24-0/7 and 33-6/7 weeks of gestation and were initiated an ACS course of betamethasone. We divided the first 48 h following the first ACS administration to four time intervals and compared each time interval to those born more than 48 h following ACS administration. The primary outcome was a composite of adverse neonatal outcome, including neonatal mortality or any major neonatal morbidity. RESULTS: A total of 200 women gave birth less than 48 h from receiving the first betamethasone injection, and 172 women gave birth within 2-7 days (48-168 h) from ACS administration. Composite adverse neonatal outcome was higher for neonates born less than 12 h from initial ACS administration compared to neonates born 2-7 days from the first betamethasone injection (55.45% vs. 29.07%, OR 3.45 95% CI [2.02-5.89], p value < 0.0001). However, there was no difference in composite adverse neonatal outcomes between neonates born 12-48 h following ACS administration and those born after 2-7 days. That was also true after adjusting for confounders. CONCLUSIONS: 12-24 h following ACS administration may be sufficient in reducing the same risk of neonatal morbidities as > 48 h following ACS administration. It may raise the question regarding the utility of the second dose of ACS.
OBJECTIVE: We assessed the association between a short antenatal corticosteroid administration-to-birth interval and neonatal outcome. STUDY DESIGN: A retrospective study was conducted between 2010 and 2020. Eligible cases were singleton preterm live-born neonates born between 24-0/7 and 33-6/7 weeks of gestation and were initiated an ACS course of betamethasone. We divided the first 48 h following the first ACS administration to four time intervals and compared each time interval to those born more than 48 h following ACS administration. The primary outcome was a composite of adverse neonatal outcome, including neonatal mortality or any major neonatal morbidity. RESULTS: A total of 200 women gave birth less than 48 h from receiving the first betamethasone injection, and 172 women gave birth within 2-7 days (48-168 h) from ACS administration. Composite adverse neonatal outcome was higher for neonates born less than 12 h from initial ACS administration compared to neonates born 2-7 days from the first betamethasone injection (55.45% vs. 29.07%, OR 3.45 95% CI [2.02-5.89], p value < 0.0001). However, there was no difference in composite adverse neonatal outcomes between neonates born 12-48 h following ACS administration and those born after 2-7 days. That was also true after adjusting for confounders. CONCLUSIONS: 12-24 h following ACS administration may be sufficient in reducing the same risk of neonatal morbidities as > 48 h following ACS administration. It may raise the question regarding the utility of the second dose of ACS.
Authors: Andrew Elimian; Reinaldo Figueroa; Alan R Spitzer; Paul L Ogburn; Vandy Wiencek; J Gerald Quirk Journal: Obstet Gynecol Date: 2003-08 Impact factor: 7.661