Antenatal corticosteroids and perinatal outcomes in infants born at 23-25 weeks of gestation

J Matern Fetal Neonatal Med. 2015;28(17):2084-9. doi: 10.3109/14767058.2014.978280. Epub 2014 Nov 25.

Abstract

Objectives: To evaluate the perinatal results of infants born between 23 and 25.6 weeks of gestation.

Methods: Medical charts of all women giving birth prematurely (23-25.6 w) from January 2005 to December 2011 were retrospectively reviewed. Cases of malformed infants or deliveries elsewhere were excluded.

Results: 198 infants were included. Chorioamnionitis occurred in 86 (43.4%) of the whole group: 26 (86.7%) in the 23-week; 35 (53.8%) in the 24-week and 25 (24.3%) in the 25-week groups. Foetal maturation with antenatal corticosteroids was complete in 119 cases (60.1%): 4 (13.3%) in the 23-week; 35 (53.8%) in the 24-week and 80 (77.7%) in the 25-week groups. Foetal death at birth occurred in 22 cases (11%) and 61 newborns (30.8%) died in the neonatal period. Of the 106 survivors with 2 years complete follow-up, 45 infants (42.4%) did not present sequelae; 16 infants (15.1%) had severe sequelae. A 66.6% (4) of infants born at 23 weeks of gestation did not present sequelae compared with a 32.3% (11) at 24 weeks and 45.4% (30) at 25 weeks.

Conclusions: The chorioamnionitis rate was higher when gestational age was lower. The foetal maturation rate was higher when gestational age was higher. A low severe sequelae rate was observed in the whole series, particularly in the 23-week group where the rate was lower than expected; however, these results could have been influenced by the small size of the 23-week group.

Keywords: Antenatal corticosteroids; cervical length; corioamnionitis; preterm birth.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Birth Weight
  • Chorioamnionitis / epidemiology
  • Female
  • Fetal Death
  • Fetal Organ Maturity / drug effects*
  • Follow-Up Studies
  • Gestational Age*
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Intensive Care, Neonatal / statistics & numerical data
  • Lung / embryology
  • Perinatal Death
  • Pregnancy
  • Pregnancy Outcome*
  • Retrospective Studies

Substances

  • Adrenal Cortex Hormones