Antenatal corticosteroids and preterm offspring outcomes in hypertensive disorders of pregnancy: A Japanese cohort study

Sci Rep. 2020 Jun 9;10(1):9312. doi: 10.1038/s41598-020-66242-z.

Abstract

To estimate whether antenatal corticosteroids (ACS) improve short- and long-term preterm offspring outcomes in singleton pregnancies complicated by hypertensive disorders of pregnancy (HDP) similar to pregnancies without HDP. This population-based retrospective study was conducted based on an analysis of data collected by the Neonatal Research Network of Japan on 21,014 singleton neonates weighing ≤1,500 g between 24 and 31 weeks' gestation during 2003-2016. Logistic regression analyses were performed to compare short- and long-term offspring outcomes between mothers receiving ACS treatment and those who did not among pregnancies with HDP and without HDP. Of 21,014 neonates, 4,806 (22.9%) were born to mothers with HDP. ACS treatment was associated with significant decreases in short-term adverse outcomes in the both HDP and non-HDP groups, with similar reduced odds of neonatal death, respiratory distress syndrome, and intraventricular haemorrhage (IVH). However, ACS treatment did not significantly decrease severe IVH (aOR 0.76; 95% CI 0.51-1.13) and periventricular leukomalacia (1.14; 0.78-1.66) in the HDP group. In addition, ACS treatment in mothers without HDP significantly decreased cerebral palsy (aOR 0.70; 95% CI 0.58-084), developmental quotient scores <85 (0.79; 0.69-0.90), and composite adverse outcomes (0.85; 0.75-0.96) at 3 years of age, whereas ACS treatment in mothers with HDP did not significantly improve these outcomes (1.04; 0.69-1.57, 1.11; 0.88-1.39, 0.96; 0.75-1.22, respectively). ACS treatment was associated with significantly decreased major short-term morbidities and mortality among extremely and very preterm neonates of mothers with HDP, with ACS treatment having a decreased effect compared to that observed in neonates of mothers without HDP. Although ACS treatment has no additional effects on offspring outcomes at 3 years of age, our results did not suggest that ACS treatment should be withheld from mothers with HDP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Birth Weight
  • Cerebral Intraventricular Hemorrhage / etiology
  • Cerebral Intraventricular Hemorrhage / mortality
  • Child, Preschool
  • Female
  • Gestational Age
  • Humans
  • Hypertension, Pregnancy-Induced / drug therapy*
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Intensive Care Units, Neonatal
  • Male
  • Maternal Age
  • Pregnancy
  • Pregnancy Outcome
  • Premature Birth / prevention & control*
  • Respiratory Distress Syndrome, Newborn / etiology
  • Respiratory Distress Syndrome, Newborn / mortality
  • Retrospective Studies

Substances

  • Adrenal Cortex Hormones

Supplementary concepts

  • Respiratory Distress Syndrome In Premature Infants