The effect of antenatal corticosteroid on incidence of respiratory distress syndrome according to maternal body mass index. |
Eun Ju Jo, Hye Min Kwak, Hyun Young Ji, Hyun Hwa Cha, Suk Joo Choi, Soo young Oh, Cheong Rae Roh, Jong Hwa Kim |
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drmaxmix.choi@samsung.com |
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Abstract |
OBJECTIVE To investigate the effects of antenatal corticosteroid (ACS) on incidence of neonatal respiratory distress syndrome (RDS) according to maternal body mass index (BMI). METHODS: We retrospectively reviewed the medical records of 715 singleton pregnant women who delivered between 24+0 and 34+0 weeks of gestation, from January 1996 to December 2006. Subjects were categorized into three groups according to ACS exposure: a nonuser group (n = 244), a single-course group (n = 377) and a multiple-course group (n = 94). Subjects were re-categorized into three groups according to maternal BMI at admission: group 1 (BMI < 23.0 kg/m2, n = 234), group 2 (BMI 23.0-24.9 kg/m2, n = 166) and group 3 (BMI > or = 25.0 kg/m2, n = 315). Univariate and multiple logistic regression analyses were used for the statistical analysis. RESULTS: Overall, the incidence of RDS was significantly lower in ACS-user groups than the non-user group, with lowest incidence in the multiple-course group (non-user vs. single-course vs. multiple-course: 44.3% vs. 41.1% vs. 11.7%, P < 0.001). The incidence of RDS was not different among the three BMI groups. Multiple logistic regression analysis showed that single- and multiple-course of ACS was significantly associated with reduced incidence of RDS: single-course, odds ratio (OR) 0.593, 95% confidence interval (CI) 0.373, 0.942; multiple-course, OR 0.085, 95% CI 0.034, 0.213. However, maternal BMI was not associated with reduced incidence of RDS with different ACS-courses (P for interaction = 0.690). CONCLUSION: ACS therapy, especially when multiple-course was used, was significantly associated with reduced incidence of RDS, but maternal BMI did not influence its effectiveness. |
Key Words:
Preterm delivery, Antenatal corticosteroid, Respiratory distress syndrome, Maternal body mass index |
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