Impact of antenatal corticosteroid therapy in very low birth weight infants on chronic lung disease and other morbidities of prematurity.

Abstract

To assess the effect of antenatal corticosteroids on very low birth weight (VLBW) infants through 36 weeks' postconceptional age. Data were collected prospectively on all VLBW (< or = 1500 gm) infants (n = 670) admitted to a single newborn intensive care unit from 1991 to 1996. Mortality rate and the frequency of medical morbidities attributable to prematurity were compared between VLBW infants who received antenatal corticosteroid therapy and those who did not. Antenatal steroid therapy was associated with a significantly lower rate of mortality (p = 0.02) and of mortality due to respiratory causes (p = 0.01). Although the frequency of chronic lung disease (oxygen requirement at 36 weeks' postconceptional age) was not significantly different between the groups (p = 0.48), the frequency of infants surviving without chronic lung disease was significantly greater in the steroid-exposed group (p = 0.02). There were no significant differences between the groups in the frequency of sepsis, necrotizing enterocolitis, length of hospital stay, or retinopathy of prematurity requiring surgery. In our study, antenatal corticosteroid therapy was associated with a beneficial effect on mortality and respiratory morbidity for VLBW infants and was not associated with any known increased risks.