P635 Impact of antenatal corticosteroid therapy on the neonatal prognosis of preterm infants born before 33 weeks of amenorrhea

Introduction Antenatal corticosteroid treatment is widely proved to be efficient in reducing hyaline membrane disease and prematurity complications. However, the effects of administering a course of corticosteroids to the mother prior to anticipated preterm birth on fetal and neonatal morbidity and mortality are still unclear. Therefore, the objective of this researchis to assess theses effects on preterm infants born before 33 weeks of amenorrhea. Patients and methods In this retrospective and descriptive study, we have considered all premature infants who were born before 33 weeks and hospitalized in the neonatology department of Sfax’s University Hospital Hedi Chaker (Tunisia) between 1 January 2014 and 31 December 2016. The short-term prognosis was compared for preterm newborns according to whether antenatal corticotherapy was performed or not. Results During the period of research, 565 premature infants born before 33 weeks of amenorrhea were hospitalized. Thus the rate of the early prematurity was 1.9%. Antenatal corticosteroids were performed in 76.1% of cases. The frequency of hyaline membrane disease was 22.8% in the presence of this corticosteroid treatment against 44.4% when it was not performed. The incidence of intracranial haemorrhage and ulcerative necrotizing enterocolitis was higher in premature infants who did not receive antenatal corticosteroid therapy. The overall hospital mortality was 25.1% in this series. It was significantly higher in the absence of antenatal corticosteroid therapy (39.3% versus 20.7%). The main causes of death were immaturity, hyaline membrane disease, nosocomial infections and intracranial haemorrhage. Conclusion The antenatal corticosteroid therapy has a great impact on mortality of preterm infants born before 33 weeks. Our findings highlight the value antenatal corticotherapy to reduce morbidity and mortality in these premature infants. Follow-up studies into childhood and adulthood, particularly in the psychomotor and neuro-development is needed and it would be especially relevant to explore this finding in adequately powered prospective trials.