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Association of antenatal steroids with surfactant administration in moderate preterm infants born to women with diabetes mellitus and/or hypertension

Journal of Perinatology volume 42, pages 993–1000 (2022)Cite this article

Subjects

Abstract

Background

Randomized trials of antenatal steroid administration (ANS) for extreme or moderate preterm pregnancies excluded women with diabetes mellitus (DM) and included few with preeclampsia.

Methods

Cohort study (n = 1,813) including moderate preterm births [290/7–336/7wks’ gestational age GA)] before (Epoch-1) and after (Epoch-2) expansion of ANS administration to women with hypertensive disorders (HTN) and/or DM. We compared surfactant administration in Group-1 (neither HTN nor DM), Group-2a (HTN not DM), Group-2b (DM not HTN) and Group-2c (DM and HTN).

Results

Surfactant administration was less frequent after ANS in Group-1 [adjusted odds ratio (aOR) 0.54, 95% confidence interval (CI) 0.31, 0.93, P = 0.03], Group-2a (aOR 0.36, CI 0.22, 0.58, P < 0.001) and Group-2c (aOR 0.29, CI 0.12, 0.71, P = 0.007) but not Group-2b (P = 0.64).

Conclusions

ANS administration was independently associated with less surfactant administration in moderately preterm neonates whose mothers had neither HTN nor DM, and those with HTN, but not those with DM without HTN.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Dr. Bloom, Dr. Leveno, Dr. McIntire, Dr. Pérez-Fontán and Dr. Savani for participating in the discussions that eventually led to expansion of ANS to mothers with DM and GHTN on 9/21/2015.

Author contributions

HMW, LPB and CRR conceptualized and designed the study. PJB, AT and LPB collected data. LPB carried out statistical analyses. HMW and LPB drafted the initial manuscript. All authors have revised the manuscript and approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Heather M. Weydig, Charles R. Rosenfeld, Myra H. Wyckoff, Mambarambath A. Jaleel, Patti J. Burchfield, Anita Thomas, Mackenzie S. Frost & Luc P. Brion

  2. Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Mackenzie S. Frost

Authors
  1. Heather M. Weydig
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  2. Charles R. Rosenfeld
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  3. Myra H. Wyckoff
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  5. Patti J. Burchfield
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  6. Anita Thomas
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  7. Mackenzie S. Frost
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  8. Luc P. Brion
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Corresponding author

Correspondence to Luc P. Brion.

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Competing interests

The authors declare no competing interests.

Ethical approval

The study was approved by the Division of Neonatal–Perinatal Medicine and Institutional Review Boards of UT Southwestern Medical Center and Parkland Health and Hospital System. The need for individual consents was waived.

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Weydig, H.M., Rosenfeld, C.R., Wyckoff, M.H. et al. Association of antenatal steroids with surfactant administration in moderate preterm infants born to women with diabetes mellitus and/or hypertension. J Perinatol 42, 993–1000 (2022). https://doi.org/10.1038/s41372-021-01273-6

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