Partial or complete antenatal steroids treatment and neonatal outcome in extremely low birth weight infants < or =1000 g: is there a dose-dependent effect?

OBJECTIVES

To assess the outcome of extremely low birth weight (ELBW) infants < or =1000 g as it relates to antenatal steroids (ANS) therapy.

STUDY DESIGN

A retrospective analysis of 124 infants born between January 1995 and December 1997. Infants born to mothers with pregnancy-induced hypertension, diabetes, and severe growth restriction were excluded. In all, 77 (62%) infants were exposed to ANS, of whom 31 (25%) received one to two doses (partial course), and 46 (37%) received three to four doses (complete course). A total of 47 infants (38%) were not exposed to ANS.

RESULTS

Infants not exposed to ANS, who exhibited more HMD, PDA, and IVH, were administered more surfactants, and were more likely to die versus infants with complete ANS dosing. Regression models revealed a dose-dependent effect of ANS on HMD, surfactant use, IVH, and CLD or death, with a significant decrease in HMD with > or =2 ANS doses.

CONCLUSIONS

ANS, in a dose-dependent way, are associated with improved outcome in ELBW infants < or =1000 g, with the best outcome seen after a complete course.