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Korean Journal of Obstetrics & Gynecology 2004;47(2):250-257.
Published online February 1, 2004.
The Benefits and Risks of Multiple Courses of Antenatal Corticosteroid Therapy in Patients with Preterm Premature Rupture of Membranes.
Soon Ha Yang, Su Ran Choi, Suk Joo Choi, Ji Soo Lee, Yong Soo Seo, Jong Hwa Kim
Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Abstract
OBJECTIVE
This study was performed to determine the benefits and risks of multiple courses of corticosteroids in patients with preterm premature rupture of membranes (PPROM). METHODS: We retrospectively evaluated the pregnancy and neonatal outcomes for women of singleton pregnancy with PPROM admitted at 24-32 weeks of gestation. Patients were categorized into 3 groups according to antenatal corticosteroids exposure: (1) non-user group, (2) single-course group, (3) multiple-course group. Chi-square test, analysis of variances, Kruskal-Wallis test, and multiple logistic regression analysis were used for statistical analyses. RESULTS: A total of 170 patients were included, with 50 in non-use group, 76 in single-course group, and 44 in multiple-course group. Univariate analyses showed that clinical chorioamnionitis occurred in the highest incidence in multiple-course group (x2=6.20, p<0.05) and the decreased incidence of RDS in multiple-course group (x2=10.0, p<0.01). Multiple logistic regression analyses demonstrated that no significant association was found after adjustment of confounding variables (odds ratio=0.28, p=0.063) whereas multiple courses of corticosteroids were independently associated with clinical chorioamnionitis (odds ratio=13.15, p=0.025). CONCLUSION: Multiple courses of antenatal corticosteroids therapy did not reduce the incidence of RDS in neonates and were associated with increased risk of clinical chorioamnionitis in patients with PPROM.
Key Words: Antenatal corticosteroids therapy, Multiple courses, Preterm premature rupture of membranes, Repiratory distress syndrome, Clinical chorioamnionitis


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