The Relationship between Antenatal Corticosteroid Administration-to-Delivery Intervals and Neonatal Respiratory Distress Syndrome and Respiratory Support

Abstract

Background. Administration of antenatal corticosteroids (ACSs) is an effective strategy for managing preterm infants, which improves neonatal respiratory distress syndrome (NRDS) and attenuates the risk of neonatal mortality. However, many preterm infants are not exposed to a complete course of ACS administration, and the effects of different ACS-to-delivery intervals on NRDS and respiratory support remain unclear. Therefore, this study explored the relationship between ACS-to-birth intervals and NRDS and respiratory support in preterm infants. Methods. In this retrospective cohort study, the preterm infants born between 240/7 and 316/7 wks of gestation were recruited from January 2015 to July 2021. All participants were categorised based on the time interval from the first ACS dose to delivery: <24 h, 1-2 d, 2–7 d, and >7 d. Multivariable logistic regression analysis examined the relationships between the ACS-to-birth interval and primary or secondary outcome while adjusting for potential confounders. Results. Of the 706 eligible neonates, 264, 83, 292, and 67 received ACS-to-delivery intervals of <24 h, 1-2 d, 2–7 d, and >7 d, respectively. After adjusting these confounding factors, the multivariable logistic analysis showed a significantly increased risk of NRDS (aOR: 1.8, 95% CI: 1.2–2.7), neonatal mortality (aOR: 2.8, 95% CI: 1.1–6.8), the need for surfactant use (aOR: 2.7, 95% CI: 1.7–4.4), endotracheal intubation in the delivery room (aOR: 1.9, 95% CI: 1.0–3.7), and mechanical ventilation (aOR: 1.9, 95% CI: 1.1–3.4) in the ACS-to-delivery interval of <24 h group when compared with the ACS-to-birth interval of 2–7 d group. Conclusions. Neonatal outcomes such as NRDS, neonatal mortality, the need for surfactant use, intubation in the delivery room, and the risk of mechanical ventilation are higher when the neonates are exposed to an ACS interval for less than 24 h before delivery.

Impact of Antenatal Steroid Administration on Neonatal Respiratory Outcomes

“…Instead, the diminished demonstration of benefit may stem from a reduction in disease burden, making it challenging to highlight this advantage. Late-preterm neonates, although less prone to Respiratory Distress Syndrome (RDS) than those born before 34 weeks, remain at risk for respiratory morbidities from alternative causes (Li et al, 2022b;Taleghani et al, 2020) The lower requirement for mechanical ventilation in the antenatal steroid group further highlights the clinical significance of this approach, mitigating the risk of respiratory complications and associated morbidities in preterm infants (Asztalos et al, 2020;Li et al, 2023;Oladapo et al, 2022). While bronchopulmonary dysplasia (BPD) rates were numerically lower in the antenatal steroid group, the lack of statistical significance may be influenced by factors such as the intricate nature of BPD development, variations in postnatal management, and the relatively modest sample size (Morhart et al, 2022;Mpinga et al, 2023).…”

Incidence of Respiratory Distress Syndrome and Its Associated Factors among Preterm Neonates: Study from West Java Tertiary Hospital

“…Previous study demonstrated a clear statistical and clinical benefit of corticosteroids on RDS from 34 weeks + 0 days gestation, but not with other primary outcomes. Thus, in very late preterm gestation women (from 35 weeks + 0 days) the use of antenatal corticosteroids needs to be considered in light of the balance of risks and benefits Li et al, 2022).…”

Retracted: The Relationship between Antenatal Corticosteroid Administration-to-Delivery Intervals and Neonatal Respiratory Distress Syndrome and Respiratory Support

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process: Discrepancies in scope Discrepancies in the description of the research reported Discrepancies between the availability of data and the research described Inappropriate citations Incoherent, meaningless and/or irrelevant content included in the article Peer-review manipulation …”

“…Tis article has been retracted by Hindawi following an investigation undertaken by the publisher [1]. Tis investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process:…”