Antenatal Glucocorticoid Treatment Decreases Mortality and Chronic Lung Disease in Survivors among 23- to 28-Week Gestational Age Preterm Infants

José Figueras-Aloy; Manuel Moro Serrano; Jesús Pérez Rodríguez; Cristina Fernández Pérez; Vicente Roqués Serradilla; José Quero Jiménez; Rafael Jiménez González; null The SEN1500 Spanish Neonatal Network

doi:10.1055/s-2005-916332

American Journal of Perinatology, Table of Contents

Am J Perinatol 2005; 22(8): 441-448
DOI: 10.1055/s-2005-916332

Antenatal Glucocorticoid Treatment Decreases Mortality and Chronic Lung Disease in Survivors among 23- to 28-Week Gestational Age Preterm Infants

José Figueras-Aloy¹ , Manuel Moro Serrano² , Jesús Pérez Rodríguez³ , Cristina Fernández Pérez² , Vicente Roqués Serradilla⁴ , José Quero Jiménez³ , Rafael Jiménez González¹ , The SEN1500 Spanish Neonatal Network⁵

¹Hospital Clínic, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Unidad Integrada de Pediatría, Universitat de Barcelona, Barcelona, Spain
²Hospital Clínico San Carlos, Madrid, Spain
³Hospital La Paz, Madrid, Spain
⁴Hospital La Fe, Valencia, Spain
⁵Contributors to the SEN1500 Spanish Neonatal Network (see Appendix)

Abstract

ABSTRACT

The purpose of this study was to analyze the influence of antenatal glucocorticoid therapy (AGT) on mortality and chronic lung disease (CLD) in surviving preterm infants 23 to 28 weeks gestational age (WGA). This was a multicenter, prospective, observational study. A total of 2448 infants 23 to 28 WGA were born in 2002 to 2003; 27.7% did not receive AGT, 18.8% were exposed to partial AGT, and 53.5% were exposed to complete AGT. A total of 883 died and 22.9% of 1537 survivors were affected by CLD. Unadjusted univariate analysis showed AGT was associated with a reduction in mortality (p < 0.001), either with partial or complete AGT courses, and also with a reduction in CLD in survivors (p < 0.001), but only with complete AGT courses. In logistic regression analysis adjusted for confounding factors and a propensity score for AGT, AGT was significant and independently associated with a reduction of mortality, but only for complete AGT course (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.47 to 0.87; p = 0.004), and with a decrease in CLD if a complete AGT course was administered (OR, 0.63; 95% CI, 0.45 to 0.89; p = 0.009). A complete course of AGT in 23 to 28 WGA pregnancies is associated with decreased rates of neonatal mortality and CLD disease in surviving infants.

KEYWORDS

Antenatal glucocorticoids - chronic lung disease - mortality - premature infants

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References

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J. Figueras-AloyM.D. Ph.D.

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