VALUE OF ANTENATAL CORTICOSTEROID-THERAPY IN PRETERM BIRTH

This prospective observational study was designed to evaluate the magn itude of the corticosteroid-related reduction in the risk of respirato ry distress syndrome (RDS), intraventricular hemorrhage and neonatal d eath according to different etiologic subgroups of preterm delivery. O f 380 patients delivered before 35 weeks' gestation, 155 received a co mplete course of dexamethasone or betamethasone to promote fetal lung maturation. In logistic models, the steroid-related reduction of RDS w as greater among patients with intact membranes as opposed to patients with premature rupture of membranes (excess risk = 0.31; 95% confiden ce interval (C.I.)= 0.13-0.73; P = 0.007) and in patients with spontan eous preterm labor as compared with other etiologic groups (excess ris k = 0.33; 95% C.I. = 0.11-0.98, P = 0.04). On the other hand, the ster oid-related reduction of severe (grade III-IV) intraventricular hemorr hage was more marked in growth retarded as opposed to well-grown fetus es (excess risk = 0.15; 95% C.I. = 0.03-0.96, P = 0.04), and in planne d as compared with spontaneous preterm deliveries (excess risk = 0.15; 95% C.I. = 0.03-0.96, P = 0.04). Results show that the greatest benef it from antenatal steroids appears to be in preterm deliveries with in tact membranes and in planned preterm deliveries.