Association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy: a multicenter cohort study
Abstract Background The relationship between antenatal corticosteroids (ACS) and preterm infants born to mothers with hypertensive disorders of pregnancy (HDP) remains a subject of debate. To evaluate whether the use of ACS before delivery was associated with neonatal outcomes in very preterm infant...
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2025-03-01
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| Series: | Italian Journal of Pediatrics |
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| Online Access: | https://doi.org/10.1186/s13052-025-01909-9 |
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| author | Mengya Sun Aimin Qian Xianghong Li Ruimiao Bai Ping Cheng Xinyue Gu Yanchen Wang Yun Cao Wenhao Zhou Shoo K. Lee Hong Jiang Siyuan Jiang on behalf of the Chinese Neonatal Network (CHNN) |
| author_facet | Mengya Sun Aimin Qian Xianghong Li Ruimiao Bai Ping Cheng Xinyue Gu Yanchen Wang Yun Cao Wenhao Zhou Shoo K. Lee Hong Jiang Siyuan Jiang on behalf of the Chinese Neonatal Network (CHNN) |
| author_sort | Mengya Sun |
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| description | Abstract Background The relationship between antenatal corticosteroids (ACS) and preterm infants born to mothers with hypertensive disorders of pregnancy (HDP) remains a subject of debate. To evaluate whether the use of ACS before delivery was associated with neonatal outcomes in very preterm infants born to mothers with HDP. Methods This multicenter cohort study enrolled all infants with gestational age at 24 to 31 week and admitted to tertiary NICUs of the Chinese Neonatal Network (CHNN) within 24 h of birth from 2019 to 2021. ACS administration was defined as at least one dose of dexamethasone or betamethasone before delivery. The primary outcome was surfactant and/ or invasive mechanical ventilation (IMV) within 72 h of life. Multivariable logistic regression analyses were performed to assess the association between ACS and neonatal outcomes. Results Among the 4,582 study infants born to mothers with HDP, 3,806 (83.1%) were exposed to ACS. ACS treatment was significantly associated with lower risk of requirement of surfactant and/ or IMV within 72 h of life (adjusted Odds Ratio = 0.60, 95% confidence interval 0.49–0.74). ACS exposure was also independently associated with decreased mortality, surfactant use, IMV, combined surfactant and IMV use and moderate or severe bronchopulmonary dysplasia. The severity of maternal HDP did not appear to influence the correlation between ACS treatment and neonatal outcomes. Our analysis also indicated that a single complete course seemed to have the most significant protective effect. Conclusions Our study reinforces the significant role of ACS in reducing severe respiratory morbidity and mortality in very preterm infants born to mothers with HDP. |
| format | Article |
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| institution | DOAJ |
| issn | 1824-7288 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | Italian Journal of Pediatrics |
| spelling | doaj-art-99fbd9af22454c68bc57532c77ee3fc42025-08-20T02:56:21ZengBMCItalian Journal of Pediatrics1824-72882025-03-0151111010.1186/s13052-025-01909-9Association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy: a multicenter cohort studyMengya Sun0Aimin Qian1Xianghong Li2Ruimiao Bai3Ping Cheng4Xinyue Gu5Yanchen Wang6Yun Cao7Wenhao Zhou8Shoo K. Lee9Hong Jiang10Siyuan Jiang11on behalf of the Chinese Neonatal Network (CHNN)Department of Neonatology, The Affiliated Hospital of Qingdao UniversityDepartment of Neonatology, Children’S Hospital of Nanjing Medical UniversityDepartment of Neonatology, The Affiliated Hospital of Qingdao UniversityDepartment of Neonatology, Northwest Women’S and Children’S HospitalDepartment of Neonatology, Children’S Hospital Affiliated to Zhengzhou UniversityNHC Key Laboratory of Neonatal Diseases, Fudan University, Children’S Hospital of Fudan UniversityNHC Key Laboratory of Neonatal Diseases, Fudan University, Children’S Hospital of Fudan UniversityNHC Key Laboratory of Neonatal Diseases, Fudan University, Children’S Hospital of Fudan UniversityDepartment of Neonatology, Children’S Hospital of Fudan UniversityMaternal-Infants Care Research Centre, Mount Sinai HospitalDepartment of Neonatology, The Affiliated Hospital of Qingdao UniversityNHC Key Laboratory of Neonatal Diseases, Fudan University, Children’S Hospital of Fudan UniversityAbstract Background The relationship between antenatal corticosteroids (ACS) and preterm infants born to mothers with hypertensive disorders of pregnancy (HDP) remains a subject of debate. To evaluate whether the use of ACS before delivery was associated with neonatal outcomes in very preterm infants born to mothers with HDP. Methods This multicenter cohort study enrolled all infants with gestational age at 24 to 31 week and admitted to tertiary NICUs of the Chinese Neonatal Network (CHNN) within 24 h of birth from 2019 to 2021. ACS administration was defined as at least one dose of dexamethasone or betamethasone before delivery. The primary outcome was surfactant and/ or invasive mechanical ventilation (IMV) within 72 h of life. Multivariable logistic regression analyses were performed to assess the association between ACS and neonatal outcomes. Results Among the 4,582 study infants born to mothers with HDP, 3,806 (83.1%) were exposed to ACS. ACS treatment was significantly associated with lower risk of requirement of surfactant and/ or IMV within 72 h of life (adjusted Odds Ratio = 0.60, 95% confidence interval 0.49–0.74). ACS exposure was also independently associated with decreased mortality, surfactant use, IMV, combined surfactant and IMV use and moderate or severe bronchopulmonary dysplasia. The severity of maternal HDP did not appear to influence the correlation between ACS treatment and neonatal outcomes. Our analysis also indicated that a single complete course seemed to have the most significant protective effect. Conclusions Our study reinforces the significant role of ACS in reducing severe respiratory morbidity and mortality in very preterm infants born to mothers with HDP.https://doi.org/10.1186/s13052-025-01909-9Antenatal CorticosteroidsNeonatal OutcomeVery Preterm InfantHypertensive Disorders of Pregnancy |
| spellingShingle | Mengya Sun Aimin Qian Xianghong Li Ruimiao Bai Ping Cheng Xinyue Gu Yanchen Wang Yun Cao Wenhao Zhou Shoo K. Lee Hong Jiang Siyuan Jiang on behalf of the Chinese Neonatal Network (CHNN) Association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy: a multicenter cohort study Italian Journal of Pediatrics Antenatal Corticosteroids Neonatal Outcome Very Preterm Infant Hypertensive Disorders of Pregnancy |
| title | Association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy: a multicenter cohort study |
| title_full | Association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy: a multicenter cohort study |
| title_fullStr | Association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy: a multicenter cohort study |
| title_full_unstemmed | Association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy: a multicenter cohort study |
| title_short | Association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy: a multicenter cohort study |
| title_sort | association between antenatal corticosteroids and neonatal outcomes among very preterm infants born to mothers with hypertensive disorders of pregnancy a multicenter cohort study |
| topic | Antenatal Corticosteroids Neonatal Outcome Very Preterm Infant Hypertensive Disorders of Pregnancy |
| url | https://doi.org/10.1186/s13052-025-01909-9 |
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