Outcome of preterm neonates born to women of a developing country at risk of preterm birth exposed to varying doses of antenatal corticosteroid: A prospective observational study

Abstract

BackgroundAntenatal corticosteroid (ACS) is used in women at risk of preterm births to reduce mortality and morbidity of the neonate born. However it's effect may not always be beneficial especially in the women with risk factors for sepsis which is quiet high in developing countries. MethodsNeonates (26–35 weeks gestational age) delivered to mothers who received 2–4 doses of ACS (group1) or 0–1 dose (group 2) were compared for incidence, severity of Respiratory distress syndrome (RDS) and death. Various morbidities of prematurity were also compared among the two groups. ResultsLess number of neonates developed RDS in group1 (28.1%) than group 2(37.8%) (p = 0.011). Few babies needed CPAP in group 1 (34.1% vs 53.9%; 0.006), however more babies needed mechanical ventilation (MV) (62.2% vs 41.7%; 0.005) in group 1. Mortality was similar (20.5% vs 20.1%; p = 0.71). Group 1 neonates with 2–4 doses of ACS had less Intraventricular hemorrhage (IVH) (0.3% vs 2.6%; p = 0.04) but sepsis rates (12% vs 6.2%; 0.02) were increased. Other morbidities of prematurity were comparable. ConclusionSimilar to the previous literature, decrease in incidence of RDS and IVH was found in neonates with higher (2–4) doses of ACS. However more cases of culture positive sepsis and severe RDS occurred in these neonates.