Antenatal Steroids Useful for Infants Born at 23 to 25 Weeks

Linked to lower rate of death, neurodevelopmental impairment at 18 to 22 months

TUESDAY, Dec. 6 (HealthDay News) -- For infants born at 23 to 25 weeks of gestation, antenatal exposure to corticosteroids is associated with a lower rate of death or neurodevelopmental impairment at 18 to 22 months, according to a study published in the Dec. 7 issue of the Journal of the American Medical Association.

Waldemar A. Carlo, M.D., from the University of Alabama in Birmingham, and colleagues investigated whether use of antenatal corticosteroids was associated with improvement in major outcomes, among 10,541 infants born with a birth weight between 401 and 1,000 grams at 22 to 25 weeks' gestation (between Jan. 1, 1993, and Dec. 31, 2009). Follow-up examinations were carried out on 4,924 infants born between 1993 and 2008, who survived to 18 to 22 months.

The investigators found that infants who had been exposed to antenatal corticosteroids and were born at 23, 24, or 25 weeks' gestation had significantly lower odds of death or neurodevelopmental impairment at 18 to 22 months (adjusted odds ratio, [aOR], 0.58, 0.62, and 0.61, respectively), but not those born at 22 weeks (aOR, 0.80; 95 percent confidence interval, 0.29 to 2.21). Events, including hospital deaths; deaths by 18 to 22 months; death, intraventricular hemorrhage, or periventricular leukomalacia; and death or necrotizing enterocolitis, occurred significantly less often in infants born at 23, 24, and 25 weeks' gestation, if their mothers received antenatal corticosteroids. The only outcome that occurred significantly less often among infants born at 22 weeks' gestation was death or necrotizing enterocolitis (aOR, 0.54).

"Antenatal corticosteroid therapy for mothers of infants born at 23, 24, and 25 weeks' gestation was associated with lower rates of both mortality and important morbidities," the authors write.

Several authors disclosed financial ties to the pharmaceutical, biotherapeutics, and physician services industries. One author disclosed providing expert testimony for various lawsuits.

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