The effects of antenatal corticosteroid and sex on morbidity and mortality in preterm infants: a cohort study

Abstract

Objective: To study the linked result of a complete course of antenatal corticosteroids (ANS) on mortality and short-term morbidity rates among preterm infants in our population. Study design: This single-center retrospective study included the infants born before 32 weeks’ gestation and admitted to neonatal intensive care unit (NICU) between January 1, 2018 and December 31, 2020. The following data of gestational age, birth weight, sex, the etiology of labor, type of delivery, need for intubation in delivery room, APGAR scores (1st and 5th min), the rates of respiratuvary distress syndrome (RDS), surfactant administration, patent ductus arteriosus (PDA), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), and bronchopulmonary dysplasia (BPD) were collected from medical records. Results: The study included 210 infants with a median gestational age of 28.6 weeks (24-31.6), a birth weight of 1065 g (445-2165) and with an ANS use rate of 80%. The mortality rate was lower (p=0.001) with a longer hospital stay (p=0.029), but the rate of BPD was higher (p=0.014) in male infants who received ANS than who did not. According to sex distribution, there was a significant decrease in mortality rate in male infants compared with female ones in ANS received group (11% vs. 23%, p=0.038) with a higher BPD rate (p=0.005). Conclusion: ANS is related with less mortality in male infants born before 32 weeks’ gestation. Further research is currently needed to evaluate advantage of antenatal steroids in different populations.