206: Does antenatal corticosteroids treatment in twin pregnancies prior to late preterm birth reduce neonatal morbidity?

Abstract

Antenatal corticosteroids (ACS) administration in the late preterm period (34/0-36/6 weeks of gestation) decreases respiratory morbidity in singleton pregnancies. However, the effect of ACS exposure in twin pregnancies has not been determined. The objective of this study was to assess whether administration of ACS during late-preterm period in twin pregnancies was associated with decreased rate of neonatal complications. A Retrospective cohort study including 209 patients with twin pregnancies who delivered in the late preterm period between 2016-2018 at a single tertiary center. Patients were allocated into two groups according to ACS exposure: 1) patients with ACS exposure (n=76, 152 neonates); and 2) patients without ACS exposure (n=133, 266 neonates). Composite respiratory morbidity was defined as the presence of respiratory distress syndrome, transient tachypnea of the newborn, mechanical ventilation, CPAP use or oxygen requirement. Multivariate logistic regression analysis was employed to adjust for maternal age and body mass index (BMI), the presence of hypertensive disease and gestational diabetes, gestational age (GA) at birth and mode of delivery. Patients exposed to ACS were older and with higher BMI compared to those without ACS exposure (Table 1). They were also more likely to give birth earlier compared to the non-exposure group with a median (interquartile range) GA of 35.6 (34.8-36.1) vs. 36.1 (35.6-36.5) weeks, respectively; p< 0.001. Caesarean delivery was more common among neonates exposed to ACS compared to those not exposed (75.7% vs. 55.3%, respectively); p< 0.001 (Table2). The rates of respiratory morbidity measures did not differ between the two groups. Nevertheless, neonates exposed to ACS had a higher rate of NICU admission as well as hypoglycaemia compared to neonates without prior ACS exposure (28.9% vs. 15.1%); p=0.001 and (48.7% vs. 27.2%); p< 0.001; respectively. Late-preterm ACS administration in twin pregnancies did not reduce the rate of neonatal respiratory morbidity but was associated with higher rates of neonatal hypoglycaemia.View Large Image Figure ViewerDownload Hi-res image Download (PPT)