Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
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Antenatal Corticosteroids and Clinical Outcomes of Preterm Singleton Neonates with Intrauterine Growth Restriction

  • Kim, Yoo Jinie (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine) ;
  • Choi, Sung Hwan (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine) ;
  • Oh, Sohee (Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center) ;
  • Sohn, Jin A (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine) ;
  • Jung, Young Hwa (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine) ;
  • Shin, Seung Han (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine) ;
  • Choi, Chang Won (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, Ee-Kyung (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, Han-Suk (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, Beyong Il (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine) ;
  • Lee, Jin A (Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine)
  • Received : 2018.07.17
  • Accepted : 2018.09.19
  • Published : 2018.11.30
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Abstract

Purpose: We assessed the influence of antenatal corticosteroid (ACS) on the inhospital outcomes of intrauterine growth restriction (IUGR) infants. Methods: A retrospective study was conducted with singletons born at $23^{+0}$ to $33^{+6}weeks$ of gestation at Seoul National University Hospital from 2007 to 2014. We compared clinical outcomes between infants who received ACS 2 to 7 days before birth (complete ACS), at <2 or >7 days (incomplete ACS), and those who did not receive ACS in IUGR and AGA infants. Multivariate logistic regression using Firth's penalized likelihood was performed. Results: 304 neonates with 91 IUGR neonates were eligible. Among AGA neonates, mortality (adjusted odds ratio [aOR], 0.13; 95% confidence interval [CI], 0.02 to 0.78), hypotension within 7 postnatal days (aOR, 0.20; 95% CI, 0.06 to 0.64), and severe bronchopulmonary dysplasia (BPD) or death (aOR, 0.24; 95% CI, 0.07 to 0.77) were lower in complete ACS group after adjusting for pregnancy induced hypertension and uncontrolled preterm labor. Mortality (aOR, 0.18; 95% CI, 0.04 to 0.78), hypotension (aOR, 0.26; 95% CI, 0.09 to 0.70), and severe BPD or death (aOR, 0.33; 95% CI, 0.12 to 0.92) were also lower in the incomplete ACS group. Among IUGR infants, after adjusting for birth weight and 5-minute Apgar score, inhaled nitric oxide use within 14 postnatal days was lower in both complete ACS (aOR, 0.07; 95% CI, 0.01 to 0.67) and incomplete ACS (aOR, 0.04; 95% CI, 0.01 to 0.37) groups. Conclusion: ACS was not effective in reducing morbidities in IUGR preterm infants.

Keywords

References

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