Benefits of maternal corticosteroid therapy in infants weighing <= 1000 grams at birth after preterm rupture of the amnion

OBJECTIVE: The aim of the study was to determine the effects of antenatal m aternal corticosteroid treatment on selected neonatal outcomes in infants w eighing less than or equal to 1000 g at birth after preterm rupture of memb ranes. STUDY DESIGN: In a 1-year (1992-1993) prospective observational study, the National Institute of Child Health and Human Development Maternal-Fetal Med icine Units Network collected outcome data for 766 infants who did not have a major fetal anomaly and who had a birth weight less than or equal to 100 0 g (378 were born after preterm rupture of membranes). Only fetuses deemed potentially viable by the obstetrician were included in our analysis. Sele cted neonatal outcomes were compared between mothers who did and did not re ceive antenatal corticosteroids. Logistic regression variables included bir th weight, sex, race, amnionitis, tocolytic therapies, mode of delivery, an d surfactant use. RESULTS: Two hundred fourteen of the 378 infants whose mothers had preterm rupture of membranes were deemed potentially viable; 62 of these mothers re ceived antenatal steroids and 152 did not. Groups were similar with respect to gestational age, birth weight, race, amnionitis, and delivery mode. Wom en who received antenatal steroids were more likely to have received tocoly sis (P < .001). Univariate and regression analyses controlling for multiple confounders confirmed no neonatal benefits of maternal corticosteroid use. CONCLUSIONS: Corticosteroid treatment in women with preterm rupture of memb ranes was of no apparent benefit to neonates weighing less than or equal to 1000 g.