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

Am J Perinatol. 2018 Oct;35(12):1213-1221. doi: 10.1055/s-0038-1642059. Epub 2018 Apr 27.


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 (290/7-336/7 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.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Delivery Rooms
  • Female
  • Gestational Age
  • Hospital Mortality
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Premature, Diseases / epidemiology
  • Infant, Premature, Diseases / prevention & control
  • Intracranial Hemorrhages / epidemiology
  • Intracranial Hemorrhages / prevention & control*
  • Logistic Models
  • Male
  • Morbidity
  • Pregnancy
  • Pregnancy Outcome
  • Prenatal Care / methods
  • Prenatal Exposure Delayed Effects*
  • Pulmonary Surfactants / therapeutic use
  • Registries
  • Respiratory Distress Syndrome, Newborn / epidemiology
  • Respiratory Distress Syndrome, Newborn / prevention & control*
  • Resuscitation / statistics & numerical data*
  • Retrospective Studies
  • United States / epidemiology


  • Adrenal Cortex Hormones
  • Pulmonary Surfactants