Correlation between antenatal corticosteroid therapy, resuscitation and mortality in very low birth weight infants

• Published in: Revista Brasileira de ginecologia e obstetrícia 2014-05, Vol.36 (5), p.211-215
• Main Authors: Drummond, Sayonara, Souza, Thaís Silva, Lima, Fernanda Goulart de, Vieira, Alan Araújo
• Format: Article
• Language: Portuguese
• Subjects: Adrenal Cortex Hormones - adverse effects; Adrenal Cortex Hormones - therapeutic use; Cohort Studies; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature, Diseases - mortality; Infant, Very Low Birth Weight; Pregnancy; Premature Birth - prevention & control; Prenatal Care; Resuscitation
• ISSN: 1806-9339
• DOI: 10.1590/S0100-7203201400050005

To evaluate the correlation between the use of antenatal corticosteroid therapy (AC), the frequency of resuscitation in delivery room and mortality of newborn infants under 1,500 g and gestational age less than or equal to 34 weeks. A cohort study was conducted on all newborn infants under 1,500 g and with a gestational age less than or equal to 34 weeks admitted at the neonatal ICU between January 2006 and December 2011. Newborns who had congenital anomalies, genetic syndromes, congenital infections and those who were transferred to or came from other institutions were excluded. The studied infants were divided into 2 groups: those who received (n=182) and those who did not receive (n=38) AC. The main outcomes studied were the necessity of neonatal resuscitation, the presence of the main neonatal diseases and mortality during hospitalization. The means of the variables were compared using Student's t-test or non-parametric test and frequencies were compared by χ2test with Fisher's correction. The variables that presented difference between groups were assessed by logistic regression. The Statistical Package for the Social Sciences (SPSS) 16.0 was used and the significance level was set at 0.05. In this study, 220 patients were evaluated. The groups were similar concerning birth weight, gestational age and the presence of the main neonatal morbidity during hospitalization. The infants who received antenatal corticosteroids showed lower mortality (OR=3.0; 95%CI 1.4-6.5) and required less resuscitation (OR=2.4; 95%CI 1.1-5.0). Besides, they required less advanced resuscitation procedures, such as tracheal cannula (OR=3.7; 95%CI 1.7-7.6), cardiac massage (OR=5.7; 95%CI 2.0-16.5) and medications (OR=8.9; 95%CI 2.0-39.4). The use of antenatal corticosteroids reduced the need for resuscitation in delivery room, especially advanced procedures, and reduced the mortality in the studied groups.