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Efficacy of single dose antenatal corticosteroid on reducing the morbidity and mortality of preterm infants: a retrospective cohort study

Mary Liezl N. Yu, MD; Agnes L. Soriano-Estrella, MD, FPOGS, FPSSTD, MHPEd
Department of Obstetrics and Gynecology, Philippine General Hospital

Objective: To determin the efficacy of a single dose of antenatal dexamethasone on the neonatal morbidity and mortality of preterm infants born between 24 weeks to 33 weeks and six days age of gestation at a tertiary government hospital.

Methods: A detailed chart review of both maternal and neonatal records of all neonates born between 24 weeks and 33 weeks and 6 days age of gestation at a tertiary government hospital from January 1, 2011 to December 31, 2013 was done. Patients were grouped based on maternal exposure to antenatal dexamethasone. After which, rate of neonatal deaths and morbidities were recorded. Chi-square test for categorical variables, independent t-test for continuous data and logistic regression were used for analysis.

Results: Seven hundred and three maternal-neonatal dyads were included. Of these, 120 (17.1%) were not exposed to any antenata corticosteroid prior to delivery, 347 (49.4%) were exposed to a single dose of 6mg dexamethasone, and 236 (33.5%) received a complete course of four doses of 6-mg dexamethasone before preterm delivery. There were better neonatal outcomes from mothers who received completed doses of antenatal corticosteroids than those who received only a single dose, however in comparison to those who have not received any antenatal corticosteroids, the group that received only a single dose had significantly better neonatal outcome. Logistic regression analysis demonstrated that exposure to a single dose of dexamethasone before delivery was associated with reduction in neonatal mortality, and select neonatal morbidities.

Conclusion: It was observed that there was improved neonatal outcomes in neonates given a single dose dexamethasone compared to those who didn't receive any antenatal corticosteroid. Obstetrician gynecologists should not hesitate in administering antenatal dexamethasone even if completion may not be feasible.