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A comparison of the clinical outcome of late preterm neonates with versus without antenatal corticosteroids

Mary Therese C. Paradiang, MD and Geraldine Isabelle B. Uyheng, MD, FPOGS
Department of Obstetrics and Gynecology, Chong Hua Hospital

Background: Preterm birth remains to be the largest cause of neonatal deaths worldwide. Improvement in preterm neonatal outcomes with antenatal corticosteroids (ACS) given to mothers at 24 to 34 weeks gestation who are at risk for preterm birth is well established. Nevertheless, the use of ACS in the late preterm, which comprises the majority of preterm births, remains an area of discussion. Recent international studies have recommended the use of ACS on the late preterm group. However, such studies in a low-income setting are lacking. Moreover, there has been no local studies and guidelines supporting the use of ACS in the late preterm.

Objective: To determine the difference in late preterm neonatal outcomes between neonates of mothers given versus those not given antenatal corticosteroids.

Materials and Methods: This was a cross sectional study done at a tertiary hospital on all singleton late preterm deliveries from 2016 to 2018. The population was divided into the no ACS and with ACS group. Data were presented in means and proportions. T test and Z test were used to determine the significant difference. Test statistic with p value less than 0.05 was considered significant.

Results: The need for intubation was higher in neonates without ACS compared to the those with ACS, whether the course was completed or not (p value=0.024). Furthermore, respiratory distress syndrome and need for surfactant was significantly higher in the no ACS group when compared to those who completed the ACS course (p value=0.024 and 0.044, respectively). Though, no significant difference was noted in the other neonatal outcomes (p values >0.05).

Conclusion: ACS, whether completed or not, resulted in a lesser need for intubation. Furthermore, a complete ACS course results in a decreased risk of respiratory distress syndrome and need for surfactant among late preterm neonates.