Relation between time interval from antenatal corticosteroids administration to delivery and neonatal outcome in twins.

Abstract

The aim of this study was to evaluate the perinatal outcome in twins, who were administered one complete course of antenatal corticosteroids (ACS) depending on the time interval from corticosteroids to delivery. We carried out a retrospective analysis of medical data of women with twins who received a course of ACS and delivered before 34 weeks within or beyond 7 days after ACS were given. Among 652 twin deliveries between 2006 and 2014, 106 met the criteria (50 patients delivered <7 days and 56 ≥ 7 days after ACS administration). There were no differences in the mean gestational age at labor, mean birthweight, perinatal mortality or newborns' general condition between women who delivered <7 and ≥7 days after corticosteroids. Newborns in the ≥7 days group suffered from respiratory disorders significantly more often (74.1% vs 54.5%, P = 0.003) and were hospitalized longer (42.6 ± 19.1 vs 33.4 ± 21.7 days, P < 0.001). Significantly more infants in the <7 days group were administered antibiotics (55.6% vs 25%, P = 0.001). In the multiple logistic regression analysis, the only factors significantly influencing the incidence of respiratory complications in twins were delivery following ACS therapy within 7 days (adjusted odds ratio, 0.16; 95% confidence interval, 0.02-0.90) and female sex (adjusted odds ratio, 0.71; 95% confidence interval 0.40-0.90). There is a relation between neonatal outcomes in twins and time interval between ACS administration and birth. Therefore, a single ACS course should be administered with caution in order to allow for the completion of the treatment without exceeding an interval of 7 days to delivery. © 2016 Japan Society of Obstetrics and Gynecology.