Comparison of interval duration between single course antenatal corticosteroid administration and delivery on neonatal outcomes.

Abstract

This study was performed to determine the effect of antenatal corticosteroid the interval between administration and delivery affect on neonatal outcomes. An observational study was performed on all deliveries between 28-34 weeks gestation where delivery occurred vaginally after completing a single course of antenatal corticosteroid (dexamethasone). Women were divided into 3 groups on the basis of the interval from first corticosteroid dose to delivery (<2 days, 2-7 and >7 days). The primary outcome was the need for neonatal resuscitation and the secondary outcome was respiratory distress syndrome (RDS), which was described as "need for ventilation with positive pressure O2 during the first 24 hrs of life". P value <0.05 was significant. Of 104 neonates whose mothers received a full course of antenatal corticosteroid, 29 delivered <2 days, 41 delivered 2-7 days, and 34 delivered more than 7 days after the initial dose. Overall, those delivering within 2 days after the first injection of corticosteroid had more need for resuscitation and ventilation than those infants delivering between 2-7 days and after 7 days. Infants delivering between 2-7 days had a lower incidence of need for resuscitation and receiving respiratory support for more than 24 hours. We found that the interval between corticosteroid administration and delivery influences the incidence of need for resuscitation and ventilation. Infants delivering less than 2 days of corticosteroid exposure have a higher frequency of need for resuscitation and ventilation than delivering between 2-7 days and after 7 days.