Antenatal glucocorticoid treatment does not reduce chronic lung disease among surviving preterm infants

Background: Antenatal glucocorticoid treatment (AGT) is associated with a n umber of postnatal benefits to the preterm infant, including reduced risk o f respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, and necrotizing enterocolitis. Objective: To evaluate the hypothesis that maternal AGT not only reduces th e risk of surfactant deficiency but also reduces the occurrence of chronic lung disease (CLD) among surviving preterm infants. Study design: Case-referent study of 1454 very low birth weight infants bor n between January 1991 and December 1993 at 4 university medical centers. Results: Rates of AGT varied among the 4 centers (11%-69%), as did rates of CLD (4%-21%), defined as a requirement for supplemental oxygen at 36 weeks ' postmenstrual age. CLD rates at each center, however, did not vary with t he rate of AGT exposure. In multivariate logistic regression analyses, AGT did not contribute significantly to CLD risk. Conclusion: AGT may play a less prominent role in modifying CLD risk than o ther factors such as biologic immaturity, infection, or neonatal intensive care unit practices, such as mechanical ventilation, continuous positive ai rway pressure, and surfactant replacement therapy.