Neonatology
Original Paper
Association of Antenatal Corticosteroids and the Mode of Delivery with the Mortality and Morbidity of Infants Weighing Less than 1,500 g at Birth in JapanSasaki Y.a · Ikeda T.b · Nishimura K.c · Katsuragi S.d · Sengoku K.e · Kusuda S.f · Fujimura M.gaDepartment of Neonatology, Otsu Red Cross Hospital, Otsu, bDepartment of Obstetrics and Gynecology, Mie University, Tsu, Departments of cPreventive Medicine and Epidemiology and dPerinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, eDepartment of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, fDepartment of Neonatology, Tokyo Women's Medical University, Tokyo, and gDepartment of Neonatology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
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Article / Publication Details
Received: August 14, 2013
Accepted: December 23, 2013
Published online: May 10, 2014
Issue release date: August 2014
Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 4
ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)
For additional information: https://www.karger.com/NEO
Abstract
Objective: This study aimed to re-evaluate the effectiveness of antenatal corticosteroids (ACS) and to analyze the association between ACS and the mode of delivery in the context of perinatal morbidity and mortality in very-low-birth-weight (VLBW) infants. Study Design: This retrospective cohort study involved 15,765 VLBW infants born between 2003 and 2008 at less than 34 weeks of gestation and weighing less than 1,500 g at birth. Data were obtained from the Japanese neonatal research network database. Univariate and multivariate logistic regression analyses were performed to evaluate the impact of ACS and mode of delivery on the risk of infant mortality and morbidity. Results: Administration of ACS was associated with decreases in mortality rate, intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP), and was not associated with the incidence of respiratory distress syndrome (RDS), periventricular leukomalacia or necrotizing enterocolitis (NEC). When the administration of ACS was analyzed in the context of different modes of delivery, the incidence of IVH and ROP tended to decrease with cesarean section deliveries, whereas the incidence of RDS tended to decrease and the incidence of NEC tended to increase for infants delivered vaginally. The incidence of chronic lung disease tended to increase in association with both delivery methods. Conclusions: This large cohort study reconfirms that ACS treatment is associated with decreases in infant mortality and severe morbidity. Furthermore, the delivery method may be associated with severe morbidity in VLBW infants exposed to ACS.
© 2014 S. Karger AG, Basel
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Article / Publication Details
Received: August 14, 2013
Accepted: December 23, 2013
Published online: May 10, 2014
Issue release date: August 2014
Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 4
ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)
For additional information: https://www.karger.com/NEO
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