(376) Late Preterm Corticosteroid Treatment in Twin Pregnancies and Neonatal Outcomes

Thursday, January 30, 2025

10:30 AM – 12:30 PM

Submitting Author and Presenting Author(s)

Victor A. Olafusi, MS

Medical Student
Indiana University School of Medicine
Indianapolis, Indiana, United States

Coauthor(s)

ER

Elizabeth Roy, BS

Medical Student
Indiana University School of Medicine
Indianapolis, Indiana, United States
Enaja Sambatur, MD (she/her/hers)

Clinical Research Specialist
Fetal Care and Surgery Center, Division of Fetal Medicine and Surgery, Boston Children’s Hospital and Harvard School of Medicine
Boston, Massachusetts, United States
Faezeh Aghajani, MD

Postdoctoral Research Fellow
Fetal Care and Surgery Center, Division of Fetal Medicine and Surgery, Boston Children’s Hospital and Harvard School of Medicine
Boston, MA, United States
Moti Gulersen, MD, MSc

Assistant Professor, Obstetrics and Gynecology
Sidney Kimmel Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania, United States
Asma Khalil, MD

Professor of Maternal Fetal Medicine
Fetal Medicine Unit, St George's Hospital, St George's University of London
London, England, United Kingdom
Vincenzo Berghella, MD (he/him/his)

Professor, Director
Sidney Kimmel Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania, United States
Hiba J. Mustafa, MD (she/her/hers)

Director of Fetal Surgery, Director of Placenta Accreta Spectrum Program
Indiana University and Riley Children's Hospital
Indianapolis, IN, United States

Objective: To examine the impact of administering late preterm corticosteroids on neonatal outcomes in twin pregnancies.

Study Design: A systematic review of the literature was conducted in four electronic databases between 2000 and 2024. Studies reporting on neonatal outcomes in twin pregnancies exposed to corticosteroid (ACS) treatment vs no treatment for fetal lung maturity at the gestational age (GA) of 34 0/7- 36 6/7 weeks were included. Studies involving participants with specific conditions (twin-to-twin transfusion syndrome and intrauterine fetal demise of one fetus) were excluded. The primary outcome was the incidence of respiratory distress syndrome (RDS). Secondary outcomes included the need for mechanical ventilation, continuous positive airway pressure (CPAP), and neonatal hypoglycemia. The random effect model was used to generate weighted mean differences (MD) and odds ratio (OR) along with their 95% confidence intervals (CI). Heterogeneity was assessed using the I2 value.

Results: 267 abstracts were screened, of which 15 full-texts were fully reviewed. Three studies were included in the final analysis which comprised 489 twin pregnancies receiving steroids and 2807 not receiving steroids. There were no significant differences in baseline characteristics compared between groups including maternal age, body mass index, rate of preeclampsia or diabetes, and type of twin chorionicity. GA at delivery was significantly earlier in the steroids group (MD -0.91, 95% CI -1.50 to -0.32). For neonatal outcomes, no significant differences in RDS and the need for mechanical ventilation between groups. There were higher chances for CPAP use (OR 2.69, 95% CI, 1.47 to 4.92) and neonatal hypoglycemia (OR 2.05, 95% CI, 1.18 to 3.56) in the steroids group.

Conclusion: This study found that antenatal corticosteroid treatment during the late-preterm period in twin pregnancies was not associated with a reduced risk of neonatal respiratory complications.