Neonatal Morbidities among Moderately Preterm Infants with and without Exposure to Antenatal Corticosteroids

Objective  We aimed to compare the rates of “surfactant treated respiratory disease” and other neonatal morbidities among moderately preterm (MPT) infants exposed to no, partial, or a complete course of antenatal corticosteroids (ANS). Study Design  This observational cohort study evaluated MPT infants (29 0/7 –33 6/7 weeks' gestational age), born between January 2012 and November 2013 and enrolled in the “MPT Registry” of the National Institute of Child Health and Human Development Neonatal Research Network. Results  Data were available for 5,886 infants, including 676 with no exposure, 1225 with partial, and 3,985 with a complete course of ANS. Among no, partial, and complete ANS groups, respectively, there were significant differences in rates of delivery room resuscitation (4.1, 1.4, and 1.2%), surfactant-treated respiratory disease (26.5, 26.3, and 20%), and severe intracranial hemorrhage (3, 2, and 0.8%). Complete ANS course was associated with lower surfactant-treated respiratory disease, compared with partial ANS (odds ratio [OR] 0.62; 95% confidence interval [CI] 0.52–0.74), and no ANS groups (OR 0.52; 95% CI 0.41–0.66) on adjusted analysis. Conclusion  In MPT infants, ANS exposure is associated with lower delivery room resuscitation, surfactant-treated respiratory disease, and severe intracranial hemorrhage; with the lowest frequency of morbidities associated with a complete course.