Association between antenatal corticosteroids and neonatal hypoglycemia in indicated early preterm births*

Spencer G. Kuper, Sima H. Baalbaki, Melissa M. Parrish, Victoria C. Jauk, Alan T. Tita, Lorie M. Harper

Research output: Contribution to journalArticle

Abstract

Purpose: We sought to determine if administration of antenatal corticosteroids in early preterm births (<34 weeks) is associated with an increased risk of developing neonatal hypoglycemia (<40 mg/dL) within the first 48 h of neonatal life. Materials and methods: Retrospective cohort of all indicated singleton preterm births (23−34 weeks) in a single tertiary center from 2011 to 2014. The primary outcome was neonatal hypoglycemia (<40 mg/dL) within the first 48 h of life. The outcome was compared by antenatal corticosteroids received at any point during the gestation, within 2–7 d of delivery, and whether the patient received a partial, full, or repeat course of antenatal corticosteroids. Logistic regression was used to adjust for confounders. Results: Six hundred thirty-five patients underwent an indicated preterm birth during the study period. Six hundred and four (95%) received antenatal corticosteroids prior to delivery and 31 (5%) did not. The incidence of neonatal hypoglycemia within 48 h of life was not significantly different between those who received any antenatal corticosteroids and those who did not (23.0 versus 16.1%, adjusted odds ratio [OR] 1.3, 95%CI 0.5–3.6). Infants who received a full antenatal corticosteroid course within 2–7 d of delivery had similar incidences of hypoglycemia compared with those who received antenatal corticosteroids more than 7 d before delivery (20.4 versus 25.4%, adjusted OR 1.5, 95% confidence interval(CI) 0.8–2.9). Neonatal hypoglycemia was not increased by the number of antenatal corticosteroid doses (partial, full, or repeat course) administered. There was not a correlation between timing of antenatal corticosteroid administration before delivery, up to 250 h, and the lowest neonatal blood sugar in the first 48 h of life. Conclusion: Our findings suggest antenatal corticosteroid administration in indicated early preterm infants (<34 weeks) may not increase the risk of developing neonatal hypoglycemia within the first 48 h of life. Further studies should validate our findings.

Original languageEnglish (US)
Pages (from-to)3095-3101
Number of pages7
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume31
Issue number23
DOIs
StatePublished - Dec 2 2018
Externally publishedYes

Fingerprint

Premature Birth
Hypoglycemia
Adrenal Cortex Hormones
Odds Ratio
Confidence Intervals
Incidence
Premature Infants
Blood Glucose
Logistic Models
Pregnancy

Keywords

  • Antenatal corticosteroids
  • indicated preterm birth
  • neonatal hypoglycemia
  • preterm birth

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Association between antenatal corticosteroids and neonatal hypoglycemia in indicated early preterm births* . / Kuper, Spencer G.; Baalbaki, Sima H.; Parrish, Melissa M.; Jauk, Victoria C.; Tita, Alan T.; Harper, Lorie M.

In: Journal of Maternal-Fetal and Neonatal Medicine, Vol. 31, No. 23, 02.12.2018, p. 3095-3101.

Research output: Contribution to journalArticle

Kuper, Spencer G. ; Baalbaki, Sima H. ; Parrish, Melissa M. ; Jauk, Victoria C. ; Tita, Alan T. ; Harper, Lorie M. / Association between antenatal corticosteroids and neonatal hypoglycemia in indicated early preterm births* In: Journal of Maternal-Fetal and Neonatal Medicine. 2018 ; Vol. 31, No. 23. pp. 3095-3101.
@article{ff17a052d7e24b20814045c0ddba0801,
title = "Association between antenatal corticosteroids and neonatal hypoglycemia in indicated early preterm births*",
abstract = "Purpose: We sought to determine if administration of antenatal corticosteroids in early preterm births (<34 weeks) is associated with an increased risk of developing neonatal hypoglycemia (<40 mg/dL) within the first 48 h of neonatal life. Materials and methods: Retrospective cohort of all indicated singleton preterm births (23−34 weeks) in a single tertiary center from 2011 to 2014. The primary outcome was neonatal hypoglycemia (<40 mg/dL) within the first 48 h of life. The outcome was compared by antenatal corticosteroids received at any point during the gestation, within 2–7 d of delivery, and whether the patient received a partial, full, or repeat course of antenatal corticosteroids. Logistic regression was used to adjust for confounders. Results: Six hundred thirty-five patients underwent an indicated preterm birth during the study period. Six hundred and four (95{\%}) received antenatal corticosteroids prior to delivery and 31 (5{\%}) did not. The incidence of neonatal hypoglycemia within 48 h of life was not significantly different between those who received any antenatal corticosteroids and those who did not (23.0 versus 16.1{\%}, adjusted odds ratio [OR] 1.3, 95{\%}CI 0.5–3.6). Infants who received a full antenatal corticosteroid course within 2–7 d of delivery had similar incidences of hypoglycemia compared with those who received antenatal corticosteroids more than 7 d before delivery (20.4 versus 25.4{\%}, adjusted OR 1.5, 95{\%} confidence interval(CI) 0.8–2.9). Neonatal hypoglycemia was not increased by the number of antenatal corticosteroid doses (partial, full, or repeat course) administered. There was not a correlation between timing of antenatal corticosteroid administration before delivery, up to 250 h, and the lowest neonatal blood sugar in the first 48 h of life. Conclusion: Our findings suggest antenatal corticosteroid administration in indicated early preterm infants (<34 weeks) may not increase the risk of developing neonatal hypoglycemia within the first 48 h of life. Further studies should validate our findings.",
keywords = "Antenatal corticosteroids, indicated preterm birth, neonatal hypoglycemia, preterm birth",
author = "Kuper, {Spencer G.} and Baalbaki, {Sima H.} and Parrish, {Melissa M.} and Jauk, {Victoria C.} and Tita, {Alan T.} and Harper, {Lorie M.}",
year = "2018",
month = "12",
day = "2",
doi = "10.1080/14767058.2017.1364724",
language = "English (US)",
volume = "31",
pages = "3095--3101",
journal = "Journal of Maternal-Fetal and Neonatal Medicine",
issn = "1476-7058",
publisher = "Informa Healthcare",
number = "23",

}

TY - JOUR

T1 - Association between antenatal corticosteroids and neonatal hypoglycemia in indicated early preterm births*

AU - Kuper, Spencer G.

AU - Baalbaki, Sima H.

AU - Parrish, Melissa M.

AU - Jauk, Victoria C.

AU - Tita, Alan T.

AU - Harper, Lorie M.

PY - 2018/12/2

Y1 - 2018/12/2

N2 - Purpose: We sought to determine if administration of antenatal corticosteroids in early preterm births (<34 weeks) is associated with an increased risk of developing neonatal hypoglycemia (<40 mg/dL) within the first 48 h of neonatal life. Materials and methods: Retrospective cohort of all indicated singleton preterm births (23−34 weeks) in a single tertiary center from 2011 to 2014. The primary outcome was neonatal hypoglycemia (<40 mg/dL) within the first 48 h of life. The outcome was compared by antenatal corticosteroids received at any point during the gestation, within 2–7 d of delivery, and whether the patient received a partial, full, or repeat course of antenatal corticosteroids. Logistic regression was used to adjust for confounders. Results: Six hundred thirty-five patients underwent an indicated preterm birth during the study period. Six hundred and four (95%) received antenatal corticosteroids prior to delivery and 31 (5%) did not. The incidence of neonatal hypoglycemia within 48 h of life was not significantly different between those who received any antenatal corticosteroids and those who did not (23.0 versus 16.1%, adjusted odds ratio [OR] 1.3, 95%CI 0.5–3.6). Infants who received a full antenatal corticosteroid course within 2–7 d of delivery had similar incidences of hypoglycemia compared with those who received antenatal corticosteroids more than 7 d before delivery (20.4 versus 25.4%, adjusted OR 1.5, 95% confidence interval(CI) 0.8–2.9). Neonatal hypoglycemia was not increased by the number of antenatal corticosteroid doses (partial, full, or repeat course) administered. There was not a correlation between timing of antenatal corticosteroid administration before delivery, up to 250 h, and the lowest neonatal blood sugar in the first 48 h of life. Conclusion: Our findings suggest antenatal corticosteroid administration in indicated early preterm infants (<34 weeks) may not increase the risk of developing neonatal hypoglycemia within the first 48 h of life. Further studies should validate our findings.

AB - Purpose: We sought to determine if administration of antenatal corticosteroids in early preterm births (<34 weeks) is associated with an increased risk of developing neonatal hypoglycemia (<40 mg/dL) within the first 48 h of neonatal life. Materials and methods: Retrospective cohort of all indicated singleton preterm births (23−34 weeks) in a single tertiary center from 2011 to 2014. The primary outcome was neonatal hypoglycemia (<40 mg/dL) within the first 48 h of life. The outcome was compared by antenatal corticosteroids received at any point during the gestation, within 2–7 d of delivery, and whether the patient received a partial, full, or repeat course of antenatal corticosteroids. Logistic regression was used to adjust for confounders. Results: Six hundred thirty-five patients underwent an indicated preterm birth during the study period. Six hundred and four (95%) received antenatal corticosteroids prior to delivery and 31 (5%) did not. The incidence of neonatal hypoglycemia within 48 h of life was not significantly different between those who received any antenatal corticosteroids and those who did not (23.0 versus 16.1%, adjusted odds ratio [OR] 1.3, 95%CI 0.5–3.6). Infants who received a full antenatal corticosteroid course within 2–7 d of delivery had similar incidences of hypoglycemia compared with those who received antenatal corticosteroids more than 7 d before delivery (20.4 versus 25.4%, adjusted OR 1.5, 95% confidence interval(CI) 0.8–2.9). Neonatal hypoglycemia was not increased by the number of antenatal corticosteroid doses (partial, full, or repeat course) administered. There was not a correlation between timing of antenatal corticosteroid administration before delivery, up to 250 h, and the lowest neonatal blood sugar in the first 48 h of life. Conclusion: Our findings suggest antenatal corticosteroid administration in indicated early preterm infants (<34 weeks) may not increase the risk of developing neonatal hypoglycemia within the first 48 h of life. Further studies should validate our findings.

KW - Antenatal corticosteroids

KW - indicated preterm birth

KW - neonatal hypoglycemia

KW - preterm birth

UR - http://www.scopus.com/inward/record.url?scp=85027498607&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027498607&partnerID=8YFLogxK

U2 - 10.1080/14767058.2017.1364724

DO - 10.1080/14767058.2017.1364724

M3 - Article

C2 - 28782409

AN - SCOPUS:85027498607

VL - 31

SP - 3095

EP - 3101

JO - Journal of Maternal-Fetal and Neonatal Medicine

JF - Journal of Maternal-Fetal and Neonatal Medicine

SN - 1476-7058

IS - 23

ER -