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Korean Journal of Obstetrics & Gynecology 2007;50(5):741-750.
Published online May 1, 2007.
The effect of multiple courses of antenatal corticosteroid therapy on perinatal outcome of the preterm neonates.
Hyun Ji Cho, Eun Sung Seo, Seung Eun Song, Kyung Lan Jung, Suk Joo Choi, Soo Young Oh, Jong Hwa Kim, Cheong Rae Roh
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. crroh@smc.samsung.co.kr
Abstract
OBJECTIVE
To investigate the effect of multiple courses of antenatal corticosteroid (ACS) therapy on perinatal outcomes, especially the respiratory distress syndrome (RDS), of the premature neonates. METHODS: We retrospectively evaluated the pregnancy and neonatal outcomes of 622 singleton pregnancies delivered at 24-34 weeks of gestation from January 1996 to December 2005. Subjects were categorized into three groups according to ACS exposure: (1) a non-user group (n=234), (2) a single-course group (n=299) and (3) a repeated-course group (n=89). Univariate and multiple logistic regression analyses were used for the incidences of RDS. RESULTS: Pregnancy outcomes including gestational age at delivery, occurrence of clinical and histological chorioamnionitis, birth weight, neonatal intensive care unit (NICU) admission rate, duration of NICU stay and neonatal mortality were similar in the three groups. The incidence of RDS was significantly lower in ACS user groups than the non-user group, with lowest incidence in multiple-course group (44.9% vs. 37.8% vs. 12.4%, p<0.001). The incidence of bronchopulmonary dysplasia and overall neonatal composite morbidity were also lowest in multiple-course group. Multivariate analysis showed that multiple courses of ACS were associated with reduced incidence of RDS (OR 0.100, 95% CI 0.042, 0.240, p<0.001) independently with gestational age at delivery, admission-to-delivery interval and premature rupture of membranes. CONCLUSION: Multiple courses of ACS administered to women with risk of preterm delivery were found to be associated with decreased incidence of RDS of the premature neonates.
Key Words: Antenatal corticosteroid, Preterm delivery, Multiple courses, Perinatal outcome, Respiratory distress syndrome


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