Repeated antenatal corticosteroid treatments - Do they reduce neonatal morbidity?

OBJECTIVE: To compare the effectiveness of single, as compared to multiple, courses of antenatal steroid treatments in reducing neonatal morbidity. STUDY DESIGN: A retrospective chart review of 204 patients who delivered pr eterm and received antenatal corticosteroids between June 1996 and December 1998 was performed and data extracted. All patients who delivered prior to 35 weeks of gestation and received corticosteroids were included. The numb er of antenatal treatments was chosen by the obstetrician caring for the pa tient as well as by the opportunity to administer steroids. RESULTS: There were 61 patients in the multiple-course group, Gestational a ge was greater in the multiple-course group (31.6 vs. 30.6, P = .03), but A pgar scores, neonatal hospital stay, specific neonatal morbidity and combin ed morbidity were not different between the two groups. Combined neonatal m orbidity was higher after three courses of antenatal steroids (29% vs. 50%) . Logistic regression analyses adjusting for gestational (We suggest a poss ible adverse effect of multiple courses, development of respiratory distres s syndrome (odds ratio 1.3; confidence interval 1.02; 1.8; P = .02) and com bined neonatal morbidity (odds ratio 1.3; confidence interval 1.04; 1.7; P = .02). CONCLUSION: Weekly antenatal steroids tic) not improve neonatal morbidity.