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Background <p>The relationship between antenatal corticosteroids (ACS) and preterm infants born to mothers with hypertensive disorders of pregnancy (HDP) remains a subject of debate. To evaluate whether the use of ACS before delivery was associated with neonatal outcomes in very preterm infants born to mothers with HDP.</p> Methods <p>This multicenter cohort study enrolled all infants with gestational age at 24 to 31&#xa0;week and admitted to tertiary NICUs of the Chinese Neonatal Network (CHNN) within 24&#xa0;h of birth from 2019 to 2021. ACS administration was defined as at least one dose of dexamethasone or betamethasone before delivery. The primary outcome was surfactant and/ or invasive mechanical ventilation (IMV) within 72&#xa0;h of life. Multivariable logistic regression analyses were performed to assess the association between ACS and neonatal outcomes.</p> Results <p>Among the 4,582 study infants born to mothers with HDP, 3,806 (83.1%) were exposed to ACS. ACS treatment was significantly associated with lower risk of requirement of surfactant and/ or IMV within 72&#xa0;h of life (adjusted Odds Ratio = 0.60, 95% confidence interval 0.49–0.74). ACS exposure was also independently associated with decreased mortality, surfactant use, IMV, combined surfactant and IMV use and moderate or severe bronchopulmonary dysplasia. The severity of maternal HDP did not appear to influence the correlation between ACS treatment and neonatal outcomes. Our analysis also indicated that a single complete course seemed to have the most significant protective effect.</p> Conclusions <p>Our study reinforces the significant role of ACS in reducing severe respiratory morbidity and mortality in very preterm infants born to mothers with HDP.</p>

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Association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy: a multicenter cohort study

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  • 发表日期：

    2025年3月13日

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  • Mengya Sun,
  • Aimin Qian,
  • Xianghong Li,
  • Ruimiao Bai,
  • Ping Cheng,
  • Xinyue Gu,
  • Yanchen Wang,
  • Yun Cao,
  • Wenhao Zhou,
  • Shoo K. Lee,
  • Hong Jiang,
  • Siyuan Jiang,
  • Lin Yuan,
  • Tongling Yang,
  • Hao Yuan,
  • Li Wang,
  • Yulan Lu,
  • Chao Chen,
  • Lizhong Du,
  • Xiuyong Chen,
  • Huayan Zhang,
  • Xiuying Tian,
  • Jingyun Shi,
  • Zhankui Li,
  • Chuanzhong Yang,
  • Ling Liu,
  • Zuming Yang,
  • Jianhua Fu,
  • Yong Ji,
  • Dongmei Chen,
  • Changyi YANG,
  • Rui Chen,
  • Xiaoming Peng,
  • Ruobing Shan,
  • Shuping Han,
  • Hui Wu,
  • Lili WANG,
  • Qiufen Wei,
  • Mingxia Li,
  • Yiheng Dai,
  • Wenqing Kang,
  • Xiaohui Gong,
  • Xiaoyun Zhong,
  • Yuan Shi,
  • Shanyu Jiang,
  • Bing Sun,
  • Long Li,
  • Zhenlang Lin,
  • Jiangqin Liu,
  • Jiahua PAN,
  • Hongping Xia,
  • Xiaoying Li,
  • Falin Xu,
  • Yinping Qiu,
  • Li Ma,
  • Ling Yang,
  • Xiaori He,
  • Yanhong Li,
  • Deyi Zhuang,
  • Qin Zhang,
  • Wenbin Dong,
  • Jianhua Sun,
  • Kun Liang,
  • Huaiyan Wang,
  • Jinxing Feng,
  • Liping Chen,
  • Xinzhu Lin,
  • Chunming Jiang,
  • Chuan Nie,
  • Linkong Zeng,
  • Mingyan Hei,
  • Hongdan Zhu,
  • Hongying MI,
  • Zhaoqing Yin,
  • Hongxia Song,
  • Hongyun Wang,
  • Dong Li,
  • Yan Gao,
  • Yajuan Wang,
  • Liying Dai,
  • Liyan ZHANG,
  • Yangfang Li,
  • Qianshen Zhang,
  • Guofang Ding,
  • Jimei Wang,
  • Xiaoxia Chen,
  • Zhen Wang,
  • Zheng Tang,
  • Xiaolu Ma,
  • Xiaomei Zhang,
  • Xiaolan Zhang,
  • Fang Wu,
  • Yanxiang Chen,
  • Ying Wu,
  • Joseph Ting

摘要

Background

The relationship between antenatal corticosteroids (ACS) and preterm infants born to mothers with hypertensive disorders of pregnancy (HDP) remains a subject of debate. To evaluate whether the use of ACS before delivery was associated with neonatal outcomes in very preterm infants born to mothers with HDP.

Methods

This multicenter cohort study enrolled all infants with gestational age at 24 to 31 week and admitted to tertiary NICUs of the Chinese Neonatal Network (CHNN) within 24 h of birth from 2019 to 2021. ACS administration was defined as at least one dose of dexamethasone or betamethasone before delivery. The primary outcome was surfactant and/ or invasive mechanical ventilation (IMV) within 72 h of life. Multivariable logistic regression analyses were performed to assess the association between ACS and neonatal outcomes.

Results

Among the 4,582 study infants born to mothers with HDP, 3,806 (83.1%) were exposed to ACS. ACS treatment was significantly associated with lower risk of requirement of surfactant and/ or IMV within 72 h of life (adjusted Odds Ratio = 0.60, 95% confidence interval 0.49–0.74). ACS exposure was also independently associated with decreased mortality, surfactant use, IMV, combined surfactant and IMV use and moderate or severe bronchopulmonary dysplasia. The severity of maternal HDP did not appear to influence the correlation between ACS treatment and neonatal outcomes. Our analysis also indicated that a single complete course seemed to have the most significant protective effect.

Conclusions

Our study reinforces the significant role of ACS in reducing severe respiratory morbidity and mortality in very preterm infants born to mothers with HDP.