학술논문

Late preterm antenatal corticosteroids in singleton and twin gestations: a retrospective cohort study
Document Type
article
Source
BMC Pregnancy and Childbirth, Vol 22, Iss 1, Pp 1-10 (2022)
Subject
Late preterm delivery
Neonatal respiratory outcomes
Betamethasone
Dexamethasone
Hypoglycemia
Late preterm infant
Gynecology and obstetrics
RG1-991
Language
English
ISSN
1471-2393
Abstract
Abstract Background In 2016, the American College of Obstetricians and Gynecologists recommended antenatal corticosteroids in the late preterm period for women at risk for preterm delivery. Limited real-world evidence exists on neonatal outcomes, particularly for twin gestations, following the guideline change. The study objective is to determine the association of antenatal corticosteroids in late preterm singleton and twin pregnancies with respiratory complications and hypoglycemia in a real-world clinical setting. Methods This is a retrospective cohort study comprising late preterm deliveries (4,341 mother–child pairs) within the Mount Sinai Health System, 2012–2018. The exposure of interest is antenatal corticosteroid administration of betamethasone during pregnancy between 34 0/7 and 36 6/7 weeks. Our primary outcomes are neonatal respiratory complications and hypoglycemia. Multivariable logistic regression was used to estimate the association between antenatal corticosteroid exposure and these two outcomes. We stratified the study population by singleton gestations and twins to minimize the potential confounding from different obstetric management between the two groups. Results Among a total of 4,341 mother–child pairs (3,309 singleton and 1,032 twin mother–child pairs), 745 mothers received betamethasone, of which 40.94% (305/745) received the full course. Relative to no treatment, a full course of betamethasone was associated with reduced odds of respiratory complications (OR = 0.53, 95% CI:[0.31–0.85], p