Antenatal corticosteroids and cranial ultrasonographic abnormalities

OBJECTIVE: This study was undertaken to determine whether very-low-birth-we ight infants whose mothers received a course of antenatal corticosteroids w ere at decreased risk for 3 cranial ultrasonographic entities that predict neurodevelopmental dysfunction. STUDY DESIGN: This retrospective cohort study evaluated 1604 infants weighi ng 500 to 1500 g who underwent greater than or equal to 1 of 3 cranial ultr asonographic scans required by design at specified postnatal intervals and whose own and mother's hospital charts were reviewed. Infants were classifi ed according to mother's course of antenatal corticosteroids (none, partial , or complete). RESULTS: In the total sample the risks of intraventricular hemorrhage and o f an echolucent image in the cerebral white matter were only modestly (and not statistically significantly) reduced after a full course of antenatal c orticosteroids, whereas antenatal corticosteroids appeared to significantly reduce the risk of ventriculomegaly after even a partial course. Antenatal corticosteroids appeared to halve the risk of ventriculomegaly and echoluc ent image among the gestationally youngest infants and those with intravent ricular hemorrhage, hypothyroxinemia, or vasculitis of the umbilical cord o r chorionic plate of the placenta. CONCLUSION: These observations are consistent with the hypothesis that ante natal corticosteroids protect very-low-birth-weight infants, especially tho se who are most vulnerable, against the risk of cranial ultrasonographic ab normalities.