International Journal of Infertility & Fetal Medicine

Register      Login

VOLUME 6 , ISSUE 3 ( September-December, 2015 ) > List of Articles

RESEARCH ARTICLE

Relationship of Time Interval between Antenatal Corticosteroid Administrations to Delivery with Respiratory Distress in Preterm Newborns

Shripad Hebbar, Lavanya Rai, Barnali Basu

Citation Information : Hebbar S, Rai L, Basu B. Relationship of Time Interval between Antenatal Corticosteroid Administrations to Delivery with Respiratory Distress in Preterm Newborns. Int J Infertil Fetal Med 2015; 6 (3):128-132.

DOI: 10.5005/jp-journals-10016-1115

License: CC BY-NC 4.0

Published Online: 01-08-2012

Copyright Statement:  Copyright © 2015; The Author(s).


Abstract

Objectives

To assess the relationship of time interval between antenatal corticosteroid administration and delivery with respiratory distress in premature newborns.

Settings

Tertiary level teaching hospital

Population

Preterm deliveries between 28 and 34 weeks in the period of April 2011 to January 2013 where the mothers received one course of corticosteroid prophylaxis and fulfilled the selection criteria.

Materials and methods

Perusal of the hospital records was made to gather antenatal information and the details of delivery and the newborn. The patients were divided based on the number of doses of steroids received into three groups. The patients receiving complete steroid prophylaxis was further divided based on the time interval between steroid administration and delivery into five groups: 0 to 7 days, 8 to 14, 15 to 21, 22 to 28, 29 days and beyond. We looked for association between neonatal respiratory outcomes and steroid-delivery intervals using Statistical Package for the Social Sciences version 16 (SPSS, Chicago, USA). Regression model was used to control for the confounding variables.

Results

There were 284 women who delivered preterm (up to 34 weeks of gestation) between April 2011 and January 2013 and fulfilled the selection criteria. The babies who received one (48) or no dose of steroids (14) had a higher incidence of respiratory distress than the ones who received a complete dose. This was statistically significant for babies born up to 32 weeks.

Among the rest 222 babies who received complete steroid prophylaxis, 138 (62%) of the neonates born were admitted in NICU, respiratory distress was seen in 62 (28%). Eleven (5%) of the babies required intubation and 22 (9%) required surfactant therapy; there were 12 (5%) neonatal deaths. Multivariable logistic regression analysis showed a slightly increased risk of respiratory morbidity with increased interval from administration to delivery (OR–0.87 for 8–14 days, 1.79 for 15–21 days and 0.16 for 22–28 days).

Conclusion

The risk of respiratory distress in preterm newborns increases beyond 2 weeks interval between antenatal corticosteroid administration and delivery.

How to cite this article

Guruvare S, Basu B, Rai L, Lewis L, Hebbar S, Adiga P. Relationship of Time Interval between Antenatal Corticosteroid Administrations to Delivery with Respiratory Distress in Preterm Newborns. Int J Infertil Fetal Med 2015;6(3): 128-132.


PDF Share
  1. Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews 2013, Issue 8.
  2. Repeat antenatal glucocorticoids for women at risk of preterm birth: a cochrane systematic review. Am J Obstet Gynecol 2012;206(3):187-194.
  3. Neonatal respiratory distress syndrome after repeat exposure to antenatal corticosteroids: a randomized controlled trial. Lancet 2006;367(9526):1913-1919.
  4. Multiple courses of antenatal corticosteroids for preterm birth (MACS): a randomized controlled trial. Lancet 2008 Dec 20;372(9656):2143-2151.
  5. Controversy: antenatal steroids. Clin Perinatol 2011;38(3):529-545.
  6. The effects of antenatal corticosteroids and surfactant replacement on neonatal respiratory distress syndrome. Bosn J Basic Med Sci 2009;9(3):225-228.
  7. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2006 Jul 19;3:CD004454.
  8. Comparison of interval duration between single course antenatal corticosteroid administration and delivery on neonatal outcomes. J Turk Ger Gynecol Assoc 2011 Jun 1;12(2):86-89.
  9. Relationship between the time interval from antenatal corticosteroid administration until preterm birth and the occurrence of respiratory morbidity. Am J Obstet Gynecol 2011;205(1):49.e1-7.
  10. Effectiveness of a rescue dose of antenatal betamethasone after an initial single course. Am J Obstet Gynecol 2001 Nov;185(5):1086-1089.
  11. The interval between a single course of antenatal steroids and delivery and its association with neonatal outcomes. Am J Obstet Gynecol 2005 Sep-(3P62);193:1165-1169.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.