A Timely Administration of Antenatal Steroids Is Highly Protective Against Intraventricular Hemorrhage: An Observational Multicenter Cohort Study of Very Low Birth Weight Infants

Frontiers in Pediatrics

article

Achim Rody¹  Christoph Härtel²  Egbert Herting³  Wolfgang Göpel³  Verena Bossung¹  Ingmar Fortmann³  Luisa Mertens¹  Hannah Boeckel³  Berthold Grüttner⁵  Alexander Humberg³  Mariana Astiz⁶  Claudia Roll⁷  Isabell Rickleffs³ 

[1] Department of Obstetrics and Gynecology, University of Lübeck;Department of Pediatrics, University Hospital of Würzburg;Department of Pediatrics, University of Lüebeck;German Center for Infection Research;Department of Obstetrics and Gynecology, University of Cologne;Center of Brain, Behavior and Metabolism, Institute of Neurobiology, University of Lübeck;Department of Pediatrics, Vestisch Children's Hospital Datteln, University Witten/Herdecke

关键词: antenatal steroids;    intraventricular hemorrhage;    VLBWI;    preterm birth;    neonatal outcome;   

DOI  :  10.3389/fped.2022.721355

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Aim The aim of the study is to evaluate the influence of the timing of antenatal steroids (ANSs) on neonatal outcome of very low birth weight infants (VLBWI) born before 30 weeks of gestation in the German Neonatal Network. Methods The German Neonatal Network is a large population-based cohort study enrolling VLBWIs since 2009. We included 672 neonates, who were born between January 1, 2009 and December 31, 2019 in our analysis in 10 selected centers. Infants were divided into four subgroups based on the interval between the first steroid administration and preterm birth: (I) two doses of betamethasone, ANS-birth interval: >24 h to 7 days, n = 187, (II) only one dose of betamethasone, ANS-birth interval 0–24 h, n = 70, (III) two doses of betamethasone, ANS-birth interval >7 days, n = 177, and (IV) no antenatal steroids, n = 238. Descriptive statistics and logistic regression analyses were performed for the main neonatal outcome parameters. Group IV (no ANS) was used as a reference. Results An ANS-birth interval of 24 h to 7 days after the first dose was associated with a reduced risk for intraventricular hemorrhage (OR 0.17; 95% CI 0.09–0.31, p 7 days was still associated with a lower risk for intraventricular hemorrhage (OR 0.43; 95% CI 0.25–0.72, p = 0.002) and the need for mechanical ventilation (OR 0.43; 95% CI 0.27–0.71, p = 0.001). Conclusion Our observational data indicate that an ANS-birth interval of 24 h to 7 days is strongly associated with a reduced risk of intraventricular hemorrhage in VLBWIs. Further research is needed to improve the prediction of preterm birth in order to achieve a timely administration of antenatal steroids that may improve neonatal outcomes such as intraventricular hemorrhage.

【 授权许可】

CC BY