Poster Session 3
Hadel Watad, MD (she/her/hers)
Physician
Sheba Medical Center
Jatt Village, HaZafon, Israel
Keren Ofir, MD
Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
Michal Fishel Bartal, MD (she/her/hers)
Maternal Fetal Medicine Faculty
UTH Houston & Sheba Medical Center Israel
Houston, TX, United States
Rakefet Yoeli-Ullman, MD
Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
Shali Mazaki-Tovi, MD
Vice Chairman
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel HaShomer
Ramat Gan, HaMerkaz, Israel
We aimed to determine neonatal outcomes following administration of rescue antenatal corticosteroid (ACS) at late preterm ( >34 weeks) after completion of initial cycle of ACS during early preterm period.
Study Design:
A retrospective cohort study including all pregnant individuals who delivered singleton late preterm infants and received first dose of ACS before 34 weeks of gestation. Individuals were divided to two groups:1. study group: Received rescue ACS >34 weeks and 2. control group: no rescue ACS after 34 weeks. Data were collected from medical records. Parametric and non-parametric statistical methods were used for analysis.
Results:
A total of 757 pregnant individuals met the inclusion criteria. Among them, 21.3% (n=161) received rescue ACS after 34 weeks of gestation, while 78.7 % (n=596) did not. Individuals who received rescue ACS had a higher median maternal age, gravidity and parity and received first course earlier during pregnancy compared to individuals without rescue dose (table 1). Neonates born to individuals who received rescue ACS had a significantly lower rates of composite neonatal outcomes compared to those who did not receive ACS (27.6% vs. 39.9%, p=0.05), lower rates of NICU admission (26.9% vs. 39.7%, P=0.003), and higher rates of neonatal fever (3.2% vs. 0.7%, P=0.027). However, rates of RDS (1.3% vs. 3.2 %, P=0.274) and composite respiratory adverse outcomes (10.3% vs. 13.8%, P=0.298) were comparable between the groups. Additionally, rates of neonatal hypoglycemia were comparable (11.8% vs. 17.4%, p=0.085 respectively). Following logistic regression and adjustment for gestational age at first ACS course, maternal age, and gravidity; those not receiving rescue ACS at late preterm had a higher rate of adverse composite neonatal outcomes [aOR 1.13, 95% CI 1.044-1.186].
Conclusion: Rescue ACS administration in late preterm was associated with reduced composite neonatal outcomes and NICU admission. However, it was not associated with a reduced rates of RDS or composite respiratory outcomes. Importantly, there was no significant difference in the prevalence of hypoglycemia.
