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  • Title: The Associations between Antenatal Corticosteroids and In-Hospital Outcomes of Preterm Singleton Appropriate for Gestational Age Neonates according to the Presence of Maternal Histologic Chorioamnionitis.
    Author: Ryu YH, Oh S, Sohn J, Lee J.
    Journal: Neonatology; 2019; 116(4):369-375. PubMed ID: 31593959.
    Abstract:
    INTRODUCTION: This study aimed to assess the association between antenatal corticosteroid (ACS) and in-hospital outcomes of preterm singleton appropriate for gestational age (AGA) infants according to the presence of maternal histologic chorioamnionitis (HCA). METHODS: A retrospective study was performed with singleton AGA neonates of 23+0 to 33+6 weeks' gestation born between 2007 and 2014. We compared the clinical outcomes according to the presence of HCA and ACS use. We also divided the ACS group into 2 groups: infants who received ACS 2-7 days before birth (optimal ACS) or not (suboptimal ACS). Multivariate logistic regression with Firth's penalized likelihood was performed. RESULTS: In total, 254 neonates were eligible with 109 neonates with HCA (42.9%). In multivariate analysis adjusting for GA, sex, and cesarean section, ACS use was associated with reduced severe bronchopulmonary dysplasia (BPD) or death and hypotension within 7 postnatal days among the neonates with HCA. However, it was associated with increased patent ductus arteriosus (PDA) treatment. In the optimal ACS group, severe BPD or death (aOR 0.03, 95% CI 0.01-0.42), hypotension (aOR 0.02, 95% CI 0.01-0.26), and inhaled nitric oxide use (aOR 0.06, 95% CI 0.00-0.81) were lower, however, PDA treatment (aOR 8.14, 95% CI 1.20-55.24) and sepsis (aOR 6.85, 95% CI 1.02-46.07) were higher when compared with the no ACS group among HCA+ infants. Among HCA- infants, only PDA treatment was lower in the ACS group. CONCLUSION: In neonates with HCA, ACS treatment was associated with reduced morbidities. However, increased sepsis was associated with optimal ACS use.
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