Antenatal steroid administration is associated with an improved chance of intact survival in preterm infants.

Abstract

Antenatal steroid administration reduces mortality in preterm infants. We used logistic regression analysis to explore the influence of various factors on intact survival in a population of 798 very low birth weight infants admitted between 1985 and 1992. Antenatal steroid administration (n = 87) was associated with an improved chance of normal survival with an odds ratio of 3.0 (95% confidence intervals from 1.5 to 5.9). Other factors associated with improved outcome were a normal cranial ultrasound image or one showing subependymal haemorrhage, female sex, a 5 min Apgar score above 5, low inspired oxygen concentration and higher birth weight. Year of birth was not associated with a consistent trend to improve outcome over this period and surfactant administration rates were constant throughout. These results endorse the current recommendations to increase the use of antenatal steroid therapy. Antenatal steroid administration was associated with a threefold improvement in the chance of normal survival for very low birth weight infants as assessed at 18 months. These results suggest that the reduction in periventricular haemorrhage after antenatal steroid use is translated into a better longterm outcome.