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The Effectiveness Of
Antenatal Corticosteroid Therapy
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Am J Obstet Gynecol. 1999 Mar;180(3 Pt 1):677-82.
Benefits of maternal corticosteroid therapy in infants weighing </=1000
grams at birth after preterm rupture of the amnion.
Chapman SJ, Hauth JC, Bottoms SF, Iams JD, Sibai B, Thom E, Moawad AH,
Thurnau GR.
Division of Maternal-Fetal Medicine, Department of Obstetrics and
Gynecology, University of Alabama at Birmingham, 35233-7333, USA.
Objectives:
The aim of the study was to determine the effects of
antenatal maternal corticosteroid treatment on selected neonatal
outcomes in infants weighing </=1000 g at birth after preterm rupture of
membranes.Study
Design:
In a 1-year (1992-1993) prospective
observational study, the National Institute of Child Health and Human
Development Maternal-Fetal Medicine Units Network collected outcome data
for 766 infants who did not have a major fetal anomaly and who had a
birth weight </=1000 g (378 were born after preterm rupture of
membranes). Only fetuses deemed potentially viable by the obstetrician
were included in our analysis. Selected neonatal outcomes were compared
between mothers who did and did not receive antenatal corticosteroids.
Logistic regression variables included birth weight, sex, race,
amnionitis, tocolytic therapies, mode of delivery, and surfactant use.
Results:
Two hundred fourteen of the 378 infants whose mothers had
preterm rupture of membranes were deemed potentially viable; 62 of these
mothers received antenatal steroids and 152 did not. Groups were similar
with respect to gestational age, birth weight, race, amnionitis, and
delivery mode. Women who received antenatal steroids were more likely to
have received tocolysis (P <.001). Univariate and regression analyses
controlling for multiple confounders confirmed no neonatal benefits of
maternal corticosteroid use.
Conclusions:
Corticosteroid treatment in
women with preterm rupture of membranes was of no apparent benefit to
neonates weighing </=1000 g.