Antenatal Steroids May Improve Outcomes in Extreme Preemies

TUESDAY, Oct. 11, 2022 — Exposure to a complete course of antenatal steroids is independently associated with greater odds of survival and survival without major morbidity among extremely preterm infants, according to a study published online Sept. 26 in JAMA Network Open.

Sanjay Chawla, M.D., from Wayne State University in Detroit, and colleagues examined the association of exposure to antenatal steroids at 22 weeks of gestational age (GA) or earlier with survival and survival without major neonatal morbidities in extremely preterm neonates. The analysis included 431 infants who were born between GA 22-0/7 and 23-6/7 weeks (2016 through 2019) and who received intensive care.

The researchers found that 25.5 percent of infants received no antenatal steroids, 18.6 percent received partial antenatal steroids, and 55.9 percent received complete antenatal steroids, with 17 infants exposed to antenatal steroids at GA 21 weeks. More than half of infants exposed to complete antenatal steroids (53.9 percent) survived to discharge versus 37.5 percent of infants with partial antenatal steroid exposure and 35.5 percent of infants with no antenatal steroids. Compared with infants without antenatal steroid exposure, infants born after complete antenatal steroid exposure were more likely to survive to discharge (adjusted odds ratio, 1.95) and to survive without major morbidity (adjusted odds ratio, 2.74).

“These data suggest that the use of antenatal steroids in patients at GA 22-6/7 weeks or less could be beneficial when active treatment is considered,” the authors write.

Abstract/Full Text

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