Effect of antenatal corticosteroids on morbidity and mortality of preterm singletons and twins.

PURPOSE

To compare the effect of antenatal corticosteroids (ACS) on neonatal outcomes among singleton and twin pregnancies and the impact of completeness and timing of ministration.

MATERIALS AND METHODS

Retrospective cohort study involving 951 preterm deliveries (25-34 weeks), between 2006 and 2015. Neonatal outcomes were evaluated according to completeness of ACS ("Complete" n = 441; "Rescue" n = 38; "Incomplete" n = 175; "No ACS" n = 98) and timing of therapy related to delivery ("Before 7 days" n = 260; "After 7 days" n = 181).

RESULTS

On respiratory distress syndrome (RDS), odds ratio (OR) for twins was 0.172, 95% confidence interval (CI) was 0.047; 0.591 and for singletons 0.390 (95%CI 0.214; 0.703) for complete or rescue courses, and 0.280 (95%CI 0.069; 1.066) for twins and 0.906 (95%CI 0.482; 1.698) for singletons for incomplete courses. About the need for mechanical ventilation (MV), twins had an OR of 0.189 (95%CI 0.052; 0.642) and singletons of 0.404 (95%CI 0.222; 0.727) for complete or rescue courses and twins had OR = 0.225 (95%CI 0.053; 0.874) and singletons of 0.404 (95%CI 0.222; 0.727) for incomplete courses. About timing, group "After 7 days" had OR = 2.00 for RDS (95%CI 1.21; 3.30) and 2.32 (95%CI 1.42; 3.78) for MV.

CONCLUSIONS

ACS improves neonatal outcomes both in singleton and twins. Delivering 7 days after a complete course decreased neonatal morbidity.