A case-control study on the effects of incomplete, one, and more than one dexamethasone course on acute respiratory problems in preterm neonates born between 28<sup>0</sup> and 36<sup>6</sup> weeks of gestation
Issued Date
2022-12-01
Resource Type
eISSN
14712393
Scopus ID
2-s2.0-85142741766
Pubmed ID
36443697
Journal Title
BMC Pregnancy and Childbirth
Volume
22
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Pregnancy and Childbirth Vol.22 No.1 (2022)
Suggested Citation
Chawanpaiboon S., Pooliam J., Chuchotiros M. A case-control study on the effects of incomplete, one, and more than one dexamethasone course on acute respiratory problems in preterm neonates born between 28<sup>0</sup> and 36<sup>6</sup> weeks of gestation. BMC Pregnancy and Childbirth Vol.22 No.1 (2022). doi:10.1186/s12884-022-05209-6 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85216
Title
A case-control study on the effects of incomplete, one, and more than one dexamethasone course on acute respiratory problems in preterm neonates born between 28<sup>0</sup> and 36<sup>6</sup> weeks of gestation
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Author's Affiliation
Other Contributor(s)
Abstract
Objective: To compare the effects of an incomplete course and more than 1 course of dexamethasone, relative to a control of a single complete course, on foetal respiratory problems and other adverse outcomes of preterm birth. Methods: This was a retrospective chart review of 1800 women with preterm delivery. Data were collected on newborns whose mothers administered 1 full course of dexamethasone (916/1800; 50.9%), a partial course (716/1800; 39.8%) and more than 1 course (168/1800; 9.3%). Demographic data and adverse maternal and neonatal outcomes were recorded. Results: Preterm singleton newborns whose mothers received several steroid hormone courses were significantly more likely to have adverse outcomes than newborns of mothers given 1 course. The negative outcomes were the need for positive pressure ventilation ([aOR] 1.831; 95% CI, (1.185,2.829); P = 0.019), ventilator support ([aOR] 1.843; 95% CI, (1.187,2.861); P = 0.011), and phototherapy ([aOR] 1.997; 95% CI, (1.378,2.895); P < 0.001), transient tachypnoea of the newborn ([aOR] 1.801; 95% CI, (1.261,2.571); P = 0.002), intraventricular haemorrhage ([aOR] 2.215; 95% CI, (1.159, 4.233); P = 0.027), sepsis ([aOR] 1.737; 95% CI, (1.086, 2.777); P = 0.007), and admission to neonatal intensive care ([aOR] 1.822; 95% CI, (1.275,2.604); P = 0.001). In the group of very preterm infants, newborns of mothers administered an incomplete course had developed respiratory distress syndrome (RDS) ([aOR] 3.177; 95% CI, (1.485, 6.795); P = 0.006) and used ventilatory support ([aOR] 3.565; 95% CI, (1.912, 6.650); P < 0.001) more than those of mothers receiving a single course. Conclusions: Preterm singleton newborns whose mothers were given multiple courses of dexamethasone had an increased incidence of RDS and other adverse outcomes than those of mothers receiving a full course. However, very preterm newborns whose mothers were administered 1 full dexamethasone course had a significantly lower incidence of RDS than those whose mothers were given partial courses.