Respiratory Morbidities and Neurodevelopmental Outcome in Preterm Infants of Mother Exposed to Antenatal Corticosteroids

Abstract

Introduction: Each year, about 15 million babies are born preterm, and 1 million babies die due to complications of preterm birth. Antenatal corticosteroid is one of the most effective evidence-based interventions that can reduce mortality and morbidity in preterm newborns. Objective: The purpose of this study was to evaluate the effect of antenatal corticosteroids on respiratory morbidities and neurodevelopmental outcomes among preterm neonates. Methodology: This prospective cohort study included admitted premature infant’s ≤ 34 weeks. Infant’s baseline demographics and maternal history of complete ACS exposure or no exposure were evaluated. Development of respiratory morbidities with support was compared between two groups during the neonatal period. After discharge from the NICU, neonates were followed up to assess neurodevelopment at 3rd and 6th months of age using Bayley Scales of Infant Development (BSID-III). Analysis was done to see the relationship with ACS exposure. Results: A total of 82 neonates were enrolled. Among them, 44 neonates in the ACS exposed group and 38 in the ACS unexposed group were assessed for the development of respiratory morbidity. Only 9(20.5%) in the ACS exposed group and 28 (73.7%) in the ACS unexposed group developed respiratory morbidities. Respiratory support with duration was also needed more in the ACS unexposed group.Neurodevelopmental assessment at 3 months was significantly lower in all three domains between the ACS exposed and unexposed groups: cognition (81.67±7.58 vs. 73.50±10.16: p-<0.001). motor (84.50±9.83 vs. 76.83±12.03, p-0.013) and language (84.67±6.33 vs.77.88±9.98, p-0.004) respectively. At 6 months, motor and language scores improved, though cognition was low in both groups. In univariate analysis, ACS exposure was found to be a significant factor in relation to normal neurodevelopment. Conclusion: Antenatal corticosteroid therapy effectively reduces respiratory morbidities in preterm neonates born ≤ 34 weeks of gestation. ACS exposure was also associated with improved neurodevelopmental outcome.