Antenatal steroids and intraventricular hemorrhage after premature rupture of membranes at 24-28 weeks' gestation

To determine whether antenatal corticosteroid administration after midtrimester premature rupture of membranes (PROM) reduces the incidence or severity of neonatal intraventricular hemorrhage, we identified a cohort of infants delivered between 24 to 28 weeks gestation (n=75) by mothers with PROM. Information was obtained from a computerized database (n=3716) of all newborns admitted to the neonatal intensive care unit at a single medical center from 1991 to 1996. We reviewed records of each mother-infant pair to determine antenatal corticosteroid administration, presence, and severity of neonatal intraventricular hemorrhage, and frequency of infectious complications. Using a logistic regression model, antenatal corticosteroid administration was associated with a significantly reduced risk of severe (grade 3-4) intraventricular hemorrhage (0.1 odds ratio, 0.006-0.57, 95% confidence interval), but not a reduced incidence of intraventricular hemorrhage (grade 1-4, 0.4 odds ratio, 0.12-1.05, 95% confidence interval).