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S. H. Yang, S. J. Choi, C. R. Roh, J. H. Kim
Multiple courses of antenatal corticosteroid therapy in patients with preterm premature rupture of membranes
Objective: This study was performed to determine the benefits and risks of multiple courses of corticosteroids in patients with preterm premature rupture of membranes (PPROM). Method: We retrospectively evaluated the pregnancy and neonatal outcomes of women with singleton pregnancies, who were admitted at 24-32 weeks of gestation due to PPROM. Patients were categorized into 3 groups according to antenatal corticosteoid exposure: (1) a nonuser group, (2) a single-course group, and (3) a multiple-course group. Result: A total of 170 patients were included in the study, with 50 in the non-use group, 76 in the single-course group, and 44 in the multiple-course group. Univariate analyses showed that clinical chorioamnionitis occurred with highest incidence in multiplecourse group (X[2]=6.20, p<0.05) and the incidence of neonatal respiratory distress syndrome (RDS) was lowest in the multiple course group (X[2]=10.0, p<0.01). Multiple logistic regression analyses showed that multiple courses of corticosteroids were independently associated with clinical chorioamnionitis (odds ratios=13.15, p<0.05) whereas no significant association was found between RDS and multiplecourse corticosteroids after adjusting for confounding variables (odds ratios=0.28, p=0.06). Conclusion: Multiple courses of antenatal corticosteroid therapy were found to be associated with an increased risk of clinical chorioamnionitis and seemed not to reduce the incidence of RDS and other neonatal morbidities in patients with PPROM.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 32, 02/2004
Pages: 42 - 48