The effect of multiple courses of antenatal steroids on neonatal infection

Abstract

Objective: The objective of this study was to determine if multiple courses of antenatal steroids in women with preterm premature rupture of membranes (PPROM) are associated with an increased incidence of neonatal sepsis.Methods: 206 women with PPROM between 22–34 weeks of gestation inclusive who did not deliver within 24 hours of admission were followed prospectively. Management included intravenous antibiotics, weekly betamethasone, daily fetal nonstress testing and twice weekly biophysical profiles. Neonatal complications including sepsis were extracted from the medical record at discharge. Fisher’s exact test was used to compare the incidence of neonatal sepsis among patients with single versus multiple courses of steroids. Significance was defined as P <0.05.Results: Ten (4.8%) neonates had the diagnosis of sepsis. The median number of steroid courses was 2 (range 1–11). No significant difference was noted between the incidence of sepsis when one course of steroids was compared with two or multiple courses.Conclusion: In our population, multiple courses of steroids do not increase the incidence of neonatal sepsis in patients with PPROM. Steroid Courses12345≥6Neonatal sepsis, n (%)6 (7.1)2 (2.7)2 (6.9)000Total (N = 206)8573291072